When muscles contract, or pull tight involuntarily, the condition is called dystonia. When the affected muscles are on the jaw, lips, or tongue, the condition is called oromandibular dystonia.
Oromandibular dystonia is also known as cranial dystonia, referring to a dystonia that affects any part of the head. Oromandibular dystonia causes strong contractions of the muscles on the face, jaw, tongue, or lips. It can cause difficulty opening or closing the mouth and can affect ones ability to speak and chew. Spasms in the tongue and clenching of the jaw can also make swallowing difficul. Oromandibular dystonia symptoms typically appear during middle age and are more common in women than in men. For some patients, activities such as speaking or chewing seem to trigger the condition. Other patients find that these activities can relieve symptoms.
Causes of dystonia
Dystonia may be inherited, or not. It can also be caused by exposure to certain drugs, by heavy metal or carbon monoxide poisoning, or by trauma to the brain resulting from stroke, brain tumor, infection, or oxygen deprivation. Early symptoms of dystonia can be mild and intermittent and are often confused with muscle fatigue.
Tricks and treatments for dystonia
In many cases, dystonia symptoms respond to a “sensory trick” to temporarily reduce symptoms. Patients with oromandibular dystonia may be able to relieve their symptoms by gently touching the lips or chin, by chewing gum, biting on a toothpick, or placing a finger near an eye or under the chin. Each case is unique, so each individual will have to experiment to find a sensory trick for his or her own symptoms.
Oromandibular dystonia treatment must also be customized for each patient.
• Oral medications - Neurotransmitters are chemicals used by the brain to control various functions, such as muscle movement. Scientists believe dystonias may be caused by abnormalities in the area of the brain where some of the messages that trigger muscle contractions are processed. Certain medications that affect the way this part of the brain processes neurotransmitters can help reduce the effects of dystonia. These medications are often more effective when used in combination, but the effectiveness may vary over time for each patient.
• Botulinum toxin – Tiny amounts of the chemical which is marketed by Allergan as Botox can provide temporary relief of dystonia symptoms. When Botox is injected into a muscle it causes that muscle to weaken, which can help relieve contractions. Botox injections wear off over time and typically need to be repeated every few months.
• Surgery – In extreme cases, surgery may be performed to destroy the thalamus, which is a part of the brain that helps control movement. Other surgeries may be performed to cut through the nerves that control the muscles that are affected by dystonia. However, this surgery includes a risk of disfigurement. The results of surgery are often unpredictable and cannot be reversed.
• Speech and swallowing therapy – A Speech-Language Pathologist can evaluate whether therapy can improve range of motion, strengthen muscles, or improve speech or swallowing.
• Deep brain stimulation – Electrical pulses delivered directly to the brain through an implanted electrode may be able to help reduce the muscle contractions of dystonia.
As the symptoms of dystonia progress, they can be increasingly painful. If you have any involuntary contractions of any muscles, it’s important to see your doctor for an evaluation.
Sources:
Dystonia Medical Research Foundation
National Institute of Neurological Disorders and Stroke
Mayo Clinic