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Oromandibular dystonia is a rare condition of hyperkinetic motor dysfunction in the orofacial area. It is a centrally mediated disorder of unknown aetiology and manifested by a sustained contraction of masticatory muscles, involving one or both lateral pterygoids, and pushing the mandible forward. The prognosis is poor and the treatment is symptomatic. This paper describes a case of a 38-year-old woman referred for a locked left TMJ who was diagnosed as having an oromandibular dystonia. A step-by-step diagnosis and treatment procedure is described.
Clinical Relevance: Knowledge of oromandibular dystonia may be valuable as rare medical diseases can be masked by common dental problems.
Article
Oromandibular dystonia is a hyperkinetic motor disorder of unknown aetiology. Its mechanism is not well understood and thought to be due to decreased neurotransmission of dopamine in the basal ganglia, as this disorder has been observed in patients with long-term use of dopamine receptor blocking drugs, such as neuroleptics.1 It is also hypothesized that, following a dental treatment, a disturbance in local neuronal circuitry might lead to an alteration of synaptic transmission in the basal ganglia which, in turn, might provoke a central reorganization of somatic representation in the thalamus. This hypothesis is not fully supported from the various dental reports and should be further examined.1,2
Several criteria have been used in the classification of dystonia. These include:
Oromandibular dystonia is a focal type of dystonia. Prevalence of this focal dystonia (29.5 cases among 100,000 individuals) is more frequent in elderly women.3,4
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