Table 1
Demographic and Clinical Characteristics of Patients with OMD.
| O-OMD | C-OMD | Total | |||
|---|---|---|---|---|---|
| Demographics | |||||
| N | 16 (59%) | 11 (41%) | 27 | ||
| Women | 56% | 64% | 59% | ||
| Caucasian | 94% | 82% | 89% | ||
| Etiology | |||||
| Idiopathic/primary | 14 (88%) | 6 (55%) | 20 (74%) | ||
| Secondary | 2 (12%) | 5 (45%) | 7 (26%) | ||
| Tardive | 0 | 2 | 2 | ||
| Peripheral1 | 1 | 1 | 2 | ||
| Degenerative | 12 | 0 | 1 | ||
| Other | 0 | 23 | 2 | ||
| Family history | |||||
| Dystonia | 1 (6%) | 1 (9%) | 2 (7%) | ||
| PD | 0 | 0 | 0 | ||
| Essential tremor | 2 (12%) | 0 | 2 (7%) | ||
| Clinical | |||||
| Age onset (SD) | 56 (14.8) | 52.6 (16.4) | 54.8 (15) | ||
| DD (≥1 year:<1 year) | 5:8 | 3:5 | 8:13 | ||
| Phenomenology | |||||
| Sensory trick | 10 (63%) | 2 (18%) | 12 (44%) | ||
| Task-specific | 1 (6%) | 1 (9%) | 2 (7%) | ||
| Focal | 11 (69%) | 4 (36%) | 15 (56%) | ||
| +Cervical | 0 | 3 (27%) | 3 (11%) | ||
| +Cranial | 3 (19%) | 1 (9%) | 4 (15%) | ||
| +Craniocervical | 2 (12%) | 2 (18%) | 4 (15%) | ||
| +Other | 0 | 1 (9%) | 1 (4%) | ||
| Weight loss | 2 (12%) | 6 (55%) | 8 (30%) | ||
| BMI (SD)4 | 27.5 (7.4) | 22.5 (7.8) | 26.4 (6.3) |
Table 2
Response to Treatment of Patients with OMD.
| O-OMD | C-OMD | ||
|---|---|---|---|
| Botulinum toxin1 | |||
| N | 11 | 8 | |
| Muscles (N/mean initial dose)2 | ABD (11/6.1 U) | Temporalis (5/9.5 U) | |
| Lat. pterygoid (5/7 U) | Masseter (7/12.9 U) | ||
| Muscles (N/mean final dose)2 | ABD (8/9.4 U) | Temporalis (5/14 U) | |
| Lat. pterygoid (2/8.8 U) | Masseter (7/34.3 U) | ||
| Other medical therapies (total/benefit3) | |||
| Anticholinergics | 4/2 | 2/0 | |
| Dopaminergic | 3/0 | 2/0 | |
| Benzodiazepines | 4/1 | 1/0 | |
| Baclofen | 1/0 | 2/1 | |
| Tizanidine | 0/0 | 1/1 | |
| Reserpine | 1/1 | 0/0 | |
| Amantadine | 1/1 | 0/0 |
ABD, anterior belly of digastric; C-, Jaw Closing; lat., lateral; O-, Jaw Opening; OMD, Oromandibular Dystonia; U, units.
1 All patients received initially botulinum toxin type A (Botox). One patient in the O-OMD group changed to botulinum toxin type B (Myobloc, dose not included in the analysis).
Figure 1
Dental Prosthesis Used in the Treatment of Oromandibular Dystonia.
(A) Occlusal view of PMMA (polymethyl methacrylate) prosthesis with built in right side “pivot” point. (B) Prosthesis seated on the maxillary teeth. (C) Patient closing on the right side “pivot” point. (D) Frontal view of prosthesis in place with right side touching and left side just out of closing contact.