How is oromandibular dystonia differentiated from hemifacial spasm?

Updated: Sep 16, 2019
  • Author: Steven Gulevich, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Oromandibular dystonia refers to dystonia affecting the lower facial musculature, predominantly the jaw, pharynx, and tongue. When oromandibular dystonia occurs in conjunction with blepharospasm, the disorder is termed Meige syndrome.

Jaw-opening forms of oromandibular dystonia indicate primary involvement of the digastric and lateral pterygoid. Jaw-closing oromandibular dystonia involves the masseter, temporalis, and medial pterygoid. Jaw deviation, indicating predominant involvement of the lateral pterygoid, is rare.

Botulinum toxin is the preferred treatment for oromandibular dystonia and is most effective in the jaw-closure type. Medications seldom yield acceptable results. When medications must be used, employ the same agents as for blepharospasm. [6] Because of the risk of aspiration, never inject botulinum toxin into the tongue.

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