Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Case Report : Botulinum Toxin Treatment in Oromandibular Dystonia

보툴리눔 톡신을 이용한 구강하악 근긴장이상증의 치료 증례

  • Ryu, Ji-Won (Department of Oral medicine, College of Dentistry, Chosun University) ;
  • Hong, Seong-Ju (Department of Oral medicine, College of Dentistry, Chosun University) ;
  • Bae, Kook-Jin (Department of Oral medicine, College of Dentistry, Chosun University) ;
  • Yoon, Chang-Lyuk (Department of Oral medicine, College of Dentistry, Chosun University) ;
  • Ahn, Jong-Mo (Department of Oral medicine, College of Dentistry, Chosun University)
  • 유지원 (조선대학교 치과대학 구강내과학교실) ;
  • 홍성주 (조선대학교 치과대학 구강내과학교실) ;
  • 배국진 (조선대학교 치과대학 구강내과학교실) ;
  • 윤창륙 (조선대학교 치과대학 구강내과학교실) ;
  • 안종모 (조선대학교 치과대학 구강내과학교실)
  • Published : 2009.12.30
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Abstract

Oromandibular dystonia is a focal neurological movement disorder characterized by involuntary sustained and often painful muscle contraction, usually producing repetitive movements or abnormal positions of the mouth, jaw and.or tongue. Patients suffering from oromandibular dystonia often experience difficulties in chewing, swallowing and speaking, resulting from the impairment of mandibular movements. At present there is no etiologic treatment for oromandibular dystonia, because the pathophysiology of primary and focal dystonia is still incompletely understood. Many treatments such as medication, behavioral therapy, surgery are suggested to decrease the involuntary movements. But these success rates are relatively low and they have a lot of complications. many studies suggested that chemodenervation with botulinum toxin is the most effective treatment for oromandibular dystonia. We reported the 2 cases which were treated oromandibular dystonia with botulinum toxin and reviewed the orofacial movement disorders(especially oromandibular dystonia) and botulinum toxin treatment for oromanfibular dystonia.

구강하악 근긴장이상증(oromandibular dystonia)은 국소적인 근긴장이상증의 한 형태로, 저작근, 안면근 또는 혀 근육의 지속적이고 반복적인 근경련이 발생하여 불수의적인 개구 및 폐구, 악골의 측방 및 후퇴운동이 나타나는 것으로 정의내릴 수 있다. 구강하악 근긴장이상증에 이환된 환자의 경우, 저작, 연하 및 발음을 하는데 불편감을 가지게 되고, 그 결과 하악 운동에 지장을 초래하게 된다. 현재까지는 근긴장이상증에 대한 병태생리가 뚜렷히 입증된 바가 없어, 원인에 관련한 치료는 이루어지지 않고 있는 상태이다. 약물요법, 행동요법, 외과적 처치 등 다양한 방법이 구강하악 근긴장이상증의 치료법으로 제시되고 있으나, 성공률이 그리 높은 편은 아니며, 많은 부작용을 초래할 수 있다. 최근 들어 근긴장이상증에 이환된 근육에 보툴리눔 톡신을 이용한 치료법이 주목을 받고 있는 추세이다. 본 증례를 통해 구강하악 근긴장이상증을 중심으로 한 구강안면 운동장애에 대하여 전반적으로 고찰을 시행하고 해당 질환에서의 보툴리눔 톡신 치료법에 대하여 알아보고자 한다.

Keywords

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