Treatment of oromandibular dystonia with botulinum toxin.

Botulinum toxin produces muscle weakness by inhibition of acetylcholine release at the neuromuscular junction. The toxin has been used successfully for symptomatic treatment of focal dystonias. Our experience in the use of botulinum toxin for the treatment of oromandibular dystonia in five patients is reported. Improvement following treatment was reported as marked by 1 patient, moderate by 1 patient, and mild by 3 patients. Similar improvement was noted by the examiners. One patient with mild cosmetic improvement developed significant dysphagia requiring feeding by a nasogastric tube for a 3-month period.