Behandlungsstrategien bei oromandibulärer Dystonie

2022

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Various movement disorders, such as oromandibular dystonia, oral dyskinesia, bruxism, functional (psychogenic) movement disorder, and tremors, exist in the stomatognathic system. Most patients experiencing involuntary movements due to these disorders visit dentists or oral surgeons, who may be the first healthcare providers. However, differential diagnoses require neurological and dental knowledge. This study aimed to review scientific advances in botulinum toxin therapy for these conditions. The results indicated that botulinum toxin injection is effective and safe, with few side effects in most cases when properly administered by an experienced clinician. The diagnosis and treatment of movement disorders in the stomatognathic system require both neurological and dental or oral surgical knowledge and skills, and well-designed multicenter trials with a multidisciplinary team approach must be necessary to ensure accurate diagnosis and proper treatment.

Section: Omdmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin Therapy for Oromandibular Dystonia and Other Movement Disorders in the Stomatognathic System

2022

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“…The procedure can help to predict the effect of the botulinum toxin therapy and whether the muscles are the cause of patients’ symptoms. If the symptoms disappear, even if only during the anesthetic effect, the injected muscles must be the cause of the symptoms, and botulinum toxin will help [ 39 ]. On the contrary, if the procedure shows no effect; there must be other causes for the patients’ symptoms, such as psychogenic factors.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study postulated that OMD has an equal or higher prevalence of cervical dystonia or blepharospasm [62]. The approaches to OMD treatment should be taken seriously not only by neurologists or neurosurgeons, but also by oral and maxillofacial surgeons or dentists [37][38][39]62]. Patients with OMD were successfully treated with BoNT/A.…”

Section: Effects Of Bont/a On Omdmentioning

confidence: 99%

“…Dystonia is a movement disorder characterized by sustained, intermittent, or task-specific muscle contractions that result in abnormal repetitive movements and/or postures [ 36 ]. Oromandibular dystonia (OMD) is a focal type of dystonia involving the masticatory, lingual, and/or muscles of the stomatognathic system [ 8 , 10 , 11 , 12 , 37 , 38 , 39 ]. Symptoms related to OMD include masticatory disturbance, restricted mouth opening capacity, muscle pain, dysphagia, dysarthria, esthetic problems, life-threatening upper airway obstructions [ 8 ], and temporomandibular joint dislocations [ 8 , 40 ].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Botulinum Toxin Type A on Pain among Trigeminal Neuralgia, Myofascial Temporomandibular Disorders, and Oromandibular Dystonia

2021

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The differences in analgesic effects of botulinum toxin type A were compared in 28 patients with trigeminal neuralgia, 53 patients with myofascial temporomandibular disorders, and 89 patients with the jaw closing oromandibular dystonia. The patients were treated by injection of botulinum toxin type A into the masseter, temporalis, medial pterygoid, and other muscles based on the symptoms of each patient. The pain severity was evaluated using the visual analog scale, pain frequency, and pain scale of the oromandibular dystonia rating scale. Botulinum toxin injection was performed 1068 times in all patients without significant adverse effects. The visual analog, pain frequency, and pain scales at baseline were reduced (p < 0.001) after two, four, eight, and 12 weeks after the first botulinum toxin therapy and at the endpoint. The effects differed significantly (p < 0.001) among the groups (repeated-measures analysis of variance). The mean improvement (0%, no effect; 100%, complete recovery) at the endpoint was 86.8% for trigeminal neuralgia, 80.8% for myofascial pain, and 75.4% for oromandibular dystonia. Injection of the botulinum toxin can be a highly effective and safe method to treat trigeminal neuralgia, myofascial pain, and oromandibular dystonia.

Effects of Botulinum Toxin Therapy on Health-Related Quality of Life Evaluated by the Oromandibular Dystonia Rating Scale

2022

Oromandibular dystonia (OMD) refers to a focal dystonia in the stomatognathic system. Health-related quality of life (HRQoL) in isolated dystonia is associated with non-motor symptoms such as depression, anxiety, and pain, as well as motor symptoms. To evaluate HRQoL in patients with OMD, the therapeutic effects of botulinum neurotoxin (BoNT) therapy were assessed using a recently developed and validated comprehensive measurement tool called the Oromandibular Dystonia Rating Scale (OMDRS). Altogether, 408 patients (jaw closing dystonia, n = 223; tongue (lingual) dystonia, n = 86; jaw opening dystonia, n = 50; jaw deviation dystonia, n = 23; jaw protrusion dystonia, n = 13; and lip (labial) dystonia, n = 13) were evaluated at baseline and after the end of BoNT therapy or in a stable status. The total OMDRS score reduced significantly from 149.1 to 57.6 (p < 0.001). Mean improvement was 63.1%. All examiner-rated subscales (severity, disability, and pain) and patient-rated questionnaire scores (general, eating, speech, cosmetic, social/family life, sleep, annoyance, mood, and psychosocial function) were significantly lower at the endpoint than at baseline (p < 0.001). The BoNT injection had a highly positive impact on patient HRQoL, and the OMDRS could evaluate both motor phenomena and non-motor symptoms.