Peripherally induced oromandibular dystonia
20.08.2015
Twenty seven patients were identified in the database with OMD, temporally and anatomically related to prior injury or surgery. No additional precipitant other than trauma could be detected. None of the patients had any litigation pending. The mean age at onset was 50.11 (SD 14.15) (range 23–74) years and there was a 2:1 female preponderance. Mean latency between the initial trauma and the onset of OMD was 65 days (range 1 day-1 year). Ten (37%) patients had some evidence of predisposing factors such as family history of movement disorders, prior exposure to neuroleptic drugs, and associated dystonia aVecting other regions or essential tremor. When compared with 21 patients with primary OMD, there was no diVerence for age at onset, female preponderance, and phenomenology. The frequency of dystonic writer’s cramp, spasmodic dysphonia, bruxism, essential tremor, and family history of movement disorder, however, was lower in the post- traumatic group (p<0.05). In both groups the response to botulinum toxin treatment was superior to medical therapy (p<0.005). Surgical intervention for temporomandibular disorders was more frequent in the post-traumatic group and was associated with worsening of dystonia. Conclusion—The study indicates that oromandibularfacial trauma, including dental procedures, may precipitate the onset of OMD, especially in predisposed people. Prompt recognition and treatment may prevent further complications.
Автор: Charulata Sankhla, Eugene C Lai, Joseph Jankovic
Год публикации: 1998
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