Question: I have had temporomandibular dystonia for 20 years, and it is getting harder to live with. Has there been new research to help dystonia patients?
Dr. Hibberd's Answer:
Temporomandibular dystonia (involutary muscle contractions of the jaw) has various origins, and treatment is directed to the underlying cause. Sometimes the dystonia has no evident structural basis, and local injection of botulism toxin by your ear, nose, and throat (ENT) specialist or oral surgeon in conjunction with your neurologist has been tremendously helpful. I assume you have been completely evaluated by your ENT, oral surgeon, and neurologist for correctable conditions that are known to underlie forms of dystonia.
Common conditions that must be evaluated for when TMJ (temporomandibular joint disorder) dystonia recurs include electrolyte, infectious, or metabolic disorders; malocclusion and TMJ syndrome amenable to oral appliances available through prescription by your oral surgeon; disc displacement at the TMJ amenable to cure by discectomy by your ENT surgeon; or a demyelinating disorder (such as multiple sclerosis) or other neurological disorder.
As you can see, much help is available depending upon the details of your case. Many patients with recurrent idiopathic dystonia will be helped with oral medications that are usually prescribed by your neurologist in conjunction with your primary care physician.
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