| CASE REPORT |
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| Year : 2019 | Volume
: 67
| Issue : 4 | Page : 1110--1111 |
Refractory Open Jaw Oromandibular Tardive Dystonia with a Sensory Trick, Treated with Botulinum Toxin: A Case Report
Ali S Shalash1, Abdelrahman Ibrahim Abushouk2, Mohammed Yasser Elsherbeny3, Hanan Elrassas4, Taha Kamel1
1 Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Medical Research Center, Faculty of Medicine, Ain Shams University, Cairo, Egypt
3 Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
4 Department of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Correspondence Address:
Prof. Ali S Shalash
Faculty of Medicine, Ain Shams University, Ramsis St, 11591, Abbasia, Cairo
Egypt
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0028-3886.266235
Jaw-opening oromandibular dystonia (O-OMD) is a clinical subtype of OMD, commonly resistant to treatment. Here, we report a distinct case of tardive O-OMD with a characteristic sensory trick, successfully treated with high-dose botulinum toxin (BTX) injection. A 34-year-old male patient presented with involuntary jaw opening, tongue protrusion, dysarthria, and mild cervical dystonia. The patient reported improved abilities to talk and close his mouth after putting something, like a cigarette, between his teeth. After an unsuccessful treatment with anticholinergic medications, the patient received electromyography-guided BTX injection to the lateral pterygoids (through an extraoral approach), sternocleidomastoids, trapezius, tongue, and platysma muscles. Following the injection, the patient reported marked improvements in his ability to talk and close his mouth without using his sensory trick. One month later, we detected a 58.2% improvement in the Abnormal Involuntary Movement Scale score. Therefore, high-dose BTX injection may be an effective alternative in refractory O-OMD.
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