Treatment of oromandibular dystonia

Abstract

Oromandibular dystonia (OMD) is a rare form of dystonia that affects the masticatory, lower facial, and lingual muscles. OMD is often idiopathic and can present as a focal dystonia or as part of a segmental or generalized pattern of dystonia. The movement phenotypes of OMD include jaw opening, jaw closing, lateral jaw deviation, lingual protrusion, and mixed presentations. Diagnosis and treatment initiation are often delayed because OMD is under-recognized. Meanwhile these patients endure significant disability, because eating and speaking are impaired, which has a negative impact on quality of life. Botulinum toxin injections are the most effective therapeutic strategy. The technique and onabotulinumA toxin doses for jaw injection are described.