Severe trismus as a complication of cerebrovascular accident: a case report.

Spastic hypertonia is a common sequelae after a cerebrovascular accident (CVA) and is a component of an upper motoneuron lesion. Management of spastic hypertonia may involve the use of centrally acting agents, peripheral blockade, and ablative therapies. We report a case of spastic hypertonia leading to severe trismus after CVA that was successfully treated with botulinum toxin type A. Severe trismus is a potentially life-threatening condition that may lead to permanent functional impairment if not promptly diagnosed and treated. Using electromyography for botulinum toxin muscle selection in this case appears to have helped decrease the dose of botulinum toxin given as well as minimize potential side effects.