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Labial dystonia after facial and trigeminal neuropathy controlled with a maxillary splint
Author(s) -
de Entrambasaguas Manuel,
PlazaCosta Andrés,
Casal Joaquín,
Parra Silvia
Publication year - 2007
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21488
Subject(s) - medicine , dystonia , facial muscles , electromyography , trigeminal nerve , palsy , infraorbital nerve , anatomy , physical medicine and rehabilitation , alternative medicine , pathology , psychiatry
A 27‐year‐old woman with bruxism suffered a spider bite ( Loxosceles rufescens ) on the left cheek that caused severe local cellulitis, facial palsy, and painful hyperesthesia over the two lower trigeminal nerve divisions. Facial but not trigeminal neuropathy improved, and she developed a labial dystonia that only corrected while pressing the right medial incisor. A specially designed maxillary splint that continuously pressed it suppressed both dystonia and related spontaneous firing of motor unit potentials in electromyography. Overstimulation of the contralateral trigeminal territory possibly compensated for the altered left trigeminal nerve input, balanced proprioceptive influences at the central inhibitory–excitatory circuitry, and controlled dystonia. © 2007 Movement Disorder Society