[Muscle afferent block in the treatment of oromandibular dystonia. Difference in effect between masticatory and lingual muscles].
Oromandibular dystonia is a neuromuscular disorder characterized by tonic or clonic involuntary spasms of the masticatory and lingual muscles. We treated 50 patients with this movement disorder by injection of lidocaine and alcohol into the masticatory or tongue muscles to block muscle afferents from muscle spindle. The patients were divided according to clinical features into four groups: jaw-closing, jaw-opening, jaw-deviation, and tongue dystonias. Objective evaluation of the symptoms before and after therapy was based on a clinical scaling protocol in terms of four parameters (mastication, speech, pain, and discomfort scales). Symptoms improved in all patients without major side effects. The overall objective improvement (60.2+/-29.5%) was significantly (P<0.005, ANOVA) lower in tongue dystonia (14.1%) than in jaw-closing dystonia (67.6%) and jaw-opening dystonia (68.3%). Although the response of the muscle afferent block to tongue dystonia was hardly satisfactory, this treatment is suggested to be effective for oromandibular dystonia.
Yoshida
K
K
Department of Oral and Maxillofacial Surgery, Kyoto University, Sakyoku, Japan. kyoshida@kuhp.kyoto-u.ac.jp
D000328:Adult; D000344:Afferent Pathways / Q000503:physiopathology*; D000368:Aged; D004334:Drug Administration Schedule; D004576:Electromyography / Q000187:drug effects; D000431:Ethanol; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008012:Lidocaine; D008297:Male; D008410:Masticatory Muscles / Q000294:innervation*; D008538:Meige Syndrome / Q000628:therapy*; D008875:Middle Aged; D009470:Muscle Spindles / Q000187:drug effects / Q000503:physiopathology; D009407:Nerve Block; D014059:Tongue / Q000294:innervation*; D016896:Treatment Outcome
D000431:Ethanol; D008012:Lidocaine