RESUMEN
Complications related to lateral pterygoid muscle (LPM) botulinum toxin A (BtA) injection for recurrent temporomandibular joint dislocation are uncommon. No cases of velopharyngeal dysfunction (VPD) following LPM BtA injection have been reported to date. This report details the perioperative and follow-up findings for a patient developing VPD following LPM BtA injection.
Asunto(s)
Toxinas Botulínicas Tipo A , Luxaciones Articulares , Trastornos de la Articulación Temporomandibular , Toxinas Botulínicas Tipo A/efectos adversos , Humanos , Luxaciones Articulares/inducido químicamente , Luxaciones Articulares/tratamiento farmacológico , Músculos PterigoideosRESUMEN
This case report presents the unusual complication of bilateral temporomandibular joint dislocation following bronchoscopy, highlighting the importance of recognising it as a differential diagnosis in patients having jaw symptoms. The delayed diagnosis in this case resulted in multiple unsuccessful reduction attempts under sedation, which added to the distress of the patient. Notably, the procedure yielded a rare diagnosis for the patient that intrinsically changed the management of her breast cancer.
Asunto(s)
Luxaciones Articulares , Neumonía , Trastornos de la Articulación Temporomandibular , Broncoscopía , Femenino , Humanos , Luxaciones Articulares/inducido químicamente , Luxaciones Articulares/diagnóstico por imagen , Paclitaxel/efectos adversos , Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/inducido químicamenteAsunto(s)
Clonazepam/efectos adversos , Moduladores del GABA/efectos adversos , Luxaciones Articulares/inducido químicamente , Trastornos de la Articulación Temporomandibular/inducido químicamente , Anciano , Femenino , Humanos , Luxaciones Articulares/complicaciones , Enfermedad de Parkinson/tratamiento farmacológico , Trastornos de la Articulación Temporomandibular/complicacionesAsunto(s)
Trastornos de la Articulación Temporomandibular/inducido químicamente , Antidepresivos/efectos adversos , Antipsicóticos/efectos adversos , Discinesia Inducida por Medicamentos/etiología , Humanos , Luxaciones Articulares/inducido químicamente , Fenotiazinas/efectos adversos , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Bruxismo del Sueño/inducido químicamenteRESUMEN
Drug induced dystonic reactions are among common presentations of patients in emergency departments, and typically occur with antidopaminergic agents as their extra-pyramidal side effects. Dystonic reactions usually occur within the first few hours or days after commencing a drug or dose increase. Unlike other extra-pyramidal side effects, a patient may experience acute dystonic reactions (ADRs) with the administration of just a single dose. Oromandibular dystonia is a subtype of dystonia which can present with perioral manifestations. In extreme cases, it can lead to temporomandibular dislocation. Haloperidol, as a high potent typical antipsychotic drug, can induce dystonia with blocking D2 dopamine receptors. The present paper reports a case of bilateral dislocation of temporomandibular joint following ingestion of haloperidol in a suicidal attempt in a 17 years old girl.
Asunto(s)
Antagonistas de Dopamina/efectos adversos , Distonía/inducido químicamente , Haloperidol/efectos adversos , Luxaciones Articulares/inducido químicamente , Intento de Suicidio , Articulación Temporomandibular/efectos de los fármacos , Adolescente , Distonía/fisiopatología , Distonía/terapia , Femenino , Humanos , Luxaciones Articulares/fisiopatología , Luxaciones Articulares/terapia , Articulación Temporomandibular/fisiopatologíaRESUMEN
A seven-year-old boy presented with a right-side mandibular luxation resulting from an acute unilateral dystonia of the masticatory muscles. Repositioning took place under a general anaesthetic. The luxation recurred the same day. Once again the jaw was repositioned under a general anaesthetic. In view of the rarity of jaw dislocation in someone so young it was assumed that it could have been caused by a dystonia possibly resulting from the patient's medication. The patient was known to have Attention Deficit Hyperactivity Disorder (ADHD). To treat the condition, the patient's psychiatrist had prescribed 1 mg risperidone daily for one year and 10 mg methylphenidate daily for two years. Following the discussion with the psychiatrist, the patient was taken off both of these drugs and instead was prescribed oxazepam. So far the luxation has not recurred.
Asunto(s)
Inhibidores de Captación de Dopamina/efectos adversos , Distonía/inducido químicamente , Luxaciones Articulares/inducido químicamente , Metilfenidato/efectos adversos , Risperidona/efectos adversos , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Niño , Inhibidores de Captación de Dopamina/uso terapéutico , Humanos , Masculino , Mandíbula , Metilfenidato/uso terapéutico , Risperidona/uso terapéuticoRESUMEN
BACKGROUND: Steroid injections into joints are frequently used to control symptomatic pain. Risks associated with intra-articular steroid injections are not well documented. METHODS: We report the case of a 29-year-old woman who was referred to a dental surgeon because of a suspected relationship between persisting chronic back pain and an arthrosis of the temporomandibular joint (TMJ). RESULTS: The dental surgeon diagnosed capsulitis of the right TMJ and injected 40 mg triamcinolone into the joint. Within 4 months the patient developed progressive pain and trismus of the right TMJ and the intra-articular injection was repeated. An occlusal splint slightly improved the patients' symptoms but induced crepitus. Magnetic resonance imaging revealed a disk dislocation in the right TMJ and severe necrosis of the condyle. The patient had persisting pain and ankylosis. Surgical restoration of the TMJ revealed a bony apposition in the fossa deformed with the socket of the joint, extensive medial erosion of the condyle and complete destruction of the disk. CONCLUSION: This case report supports earlier observations that intra-articular glucocorticoid injections, if used in a wrong way, may cause severe destruction of a joint.
Asunto(s)
Antiinflamatorios/efectos adversos , Glucocorticoides/efectos adversos , Trastornos de la Articulación Temporomandibular/inducido químicamente , Triamcinolona/efectos adversos , Adulto , Anquilosis/inducido químicamente , Antiinflamatorios/administración & dosificación , Cartílago Articular/efectos de los fármacos , Femenino , Glucocorticoides/administración & dosificación , Humanos , Inyecciones Intraarticulares , Luxaciones Articulares/inducido químicamente , Cóndilo Mandibular/efectos de los fármacos , Necrosis , Disco de la Articulación Temporomandibular/efectos de los fármacos , Triamcinolona/administración & dosificación , Trismo/inducido químicamenteRESUMEN
Botulinum toxin (BTX) has been used successfully to treat various movement disorders, and is increasingly used for many other medical conditions. Sialorrhoea is a disabling symptom in many neurological patients including those with Parkinson's disease, stroke and amyotrophic lateral sclerosis (ALS). BTX has recently been shown to be effective for treating sialorrhoea. We report an ALS patient who developed recurrent jaw dislocation following BTX treatment for sialorrhoea to highlight the observation that intraparotid BTX may be complicated by jaw dislocations in some at-risk ALS patients. Clinicians using BTX to treat sialorrhoea in ALS need to be aware of this potentially serious complication.