Oromandibular dystonia, also referred to as cranial dystonia or Meige’s syndrome, is a neurological or nervous system movement disorder which causes involuntary, forceful contractions of the mouth area including the neck, face, jaw or tongue. This condition can make opening and closing the mouth difficult. It can also impair speech, swallowing and chewing.
This type of muscle spasm can occur with or without a familial history of dystonia, or muscle spasms. However, oromandibular dystonia is thought to be caused by a problem with the basal ganglia. The basal ganglia are structures inside the brain that control movement. This condition is also thought to be brought about by secondary causes such as stress, fatigue, drug exposure and disorders such as Wilson’s disease.
Wilson’s disease is an inherited copper metabolism disorders causing an accumulation of copper in the vital organs such as the liver and brain. This potentially life-threatening disorder can cause tremors and muscle spasms. Tremors are involuntary, rhythmic muscle movements whereas muscle spasms are involuntary contractions or tightening of muscles. Wilson’s disease is also associated with face and mouth problems such as difficulties with speech and drooling.
Oromandibular dystonia can present with dystonia or movement abnormalities in the neck, throat, face and mouth area, in combination or singularly. Since symptoms vary and there is no standardized test to confirm the presence of oromandibular dystonia, diagnosis of this condition is made through a comprehensive physical and neurological examination. Treatment options for oromandibular dystonia can also vary according to symptoms. Occasionally, medications which affect the neurotransmitter chemicals, or the messenger chemicals between the nerves and muscles, provide relief of symptoms. Some examples of these types of medications include benzodiazepines, such as Valium®, and dopamine-depleting agents, such as levadopa.
Another common treatment for oromandibular dystonia is botulinum toxin injections. This biological product derived from a specific form of bacteria to block the neurotransmitters, is injected into specific affected muscles to reduce or eliminate the involuntary contractions of the necks, face and mouth area. These injections typically work well with dystonias involving involuntary mouth closures.
Noninvasive treatment options include sensory tricks, such as chewing gum or placing a finger under the chin. These noninvasive techniques can provide a temporary cessation of the symptoms. Strengthening of surrounding muscles and stretching of the entire affected area may help decrease symptoms. Speech therapy involving swallowing techniques may also provide with coping strategies and overall movement control. General techniques to reduce stress levels may also contribute to a decrease in oromandibular dystonia symptoms.
