Focal dystonia of the muscles of the mouth, tongue and lower jaw is called oromandibular dystonia (OMD) (Latin oris = mouth, mandibula = lower jaw). If eyelid spasm is present in addition to dystonia of the lower half of the head, this is called Meige syndrome, which was first described in 1910 by eye specialist Henry Meige. Illustrations of this form of focal dystonia do not occur until much later, however.
The British neurologist David Marsden, who in 1976 classified blepharospasm and OMD among the organically determined forms of dystonia, pointed out that the pictures of P. Brueghel the Elder show people with spasms of the facial and mandibular muscles. The portrait “Yawning Man” of 1558 shows a man with his eyes screwed up and his mouth wide open. For this reason the medical literature sometimes also refers to Brueghel’s syndrome.
The involuntary movements affect three different groups of muscles. The first that must be mentioned are the mimetic ones, i.e. those which control facial expressions. This is shown by the involuntary tensing of the eye, mouth and neck muscles. Patients with Meige syndrome often find the eyelid spasms more troublesome than movements around the mouth area. The second group are the mandibular or masticatory muscles which are responsible for powerful biting movements and for grinding, chewing movements. OMD can, depending on the jaw movement, be subdivided into a type with jaw opening and one with jaw closure. The third muscle group contains the tongue and the pharyngeal muscles. In OMD, the tongue may constantly move in all directions. Speaking and swallowing may become completely impossible for particularly severely affected patients. Abnormal movements of the pharynx manifest themselves as a “lump in the throat” or through choking.
The involuntary movements of OMD increase under stress and emotional tension but decrease at rest and relaxation, and disappear completely during sleep. They are intensified by active movements, such as speaking.
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Stand: 18.10.2007, 11:51 Uhr
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