Jaw tremor is usually associated with tremor or other abnormal involuntary movements affecting additional body parts, but isolated jaw tremor is a rare clinical presentation. A 40-year-old man presented with history of paroxysmal jaw tremor for 3 years with no other neurological symptoms, psychiatric conditions, or a family history of neurological disorders. The tremor occurred only in the resting jaw position, with 10 episodes per day on an average, and lasted from 10 minutes to hours. It disappeared with any voluntary activation of the masseter muscle and did not change (in amplitude or frequency) with distraction maneuvers. The remainder of neurologic examination was unremarkable. The patient underwent extensive testing, including contrast-enhanced brain magnetic resonance imaging, blood tests and neuropsychiatric evaluation by two different neuropsychiatrists which failed to reveal the underlying cause. The needle electromyography examination revealed involuntary, intermittent, and synchronized muscular contractions in both masseter muscles, at a frequency of 13 to 14 Hz. No changes were discovered in the other muscles. He was treated with propranolol, primidone, valproic acid, diazepam, and amitriptyline, but the response was not significant. Injection of 25 units of botulinum toxin type A in the masseter muscle on both sides of the fac was effective five days after the injection. No adverse effects or masseter weakness were observed.
| Published in | Clinical Neurology and Neuroscience (Volume 4, Issue 3) |
| DOI | 10.11648/j.cnn.20200403.14 |
| Page(s) | 61-65 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
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Copyright © The Author(s), 2020. Published by Science Publishing Group |
Paroxysmal Isolated Jaw Tremor, Primary Orthostatic Tremor, Botulinum Toxin
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APA Style
Rafaela Magalhães Britto Pacheco de Moraes, Fernando José de Souza, João Fellipe Santos Tatsch, Livia Souza Santos, José Furtado Alves Junior, et al. (2020). Orthostatic Jaw Tremor, a Diagnostic Challenge for Neurologists. Clinical Neurology and Neuroscience, 4(3), 61-65. https://doi.org/10.11648/j.cnn.20200403.14
ACS Style
Rafaela Magalhães Britto Pacheco de Moraes; Fernando José de Souza; João Fellipe Santos Tatsch; Livia Souza Santos; José Furtado Alves Junior, et al. Orthostatic Jaw Tremor, a Diagnostic Challenge for Neurologists. Clin. Neurol. Neurosci. 2020, 4(3), 61-65. doi: 10.11648/j.cnn.20200403.14
AMA Style
Rafaela Magalhães Britto Pacheco de Moraes, Fernando José de Souza, João Fellipe Santos Tatsch, Livia Souza Santos, José Furtado Alves Junior, et al. Orthostatic Jaw Tremor, a Diagnostic Challenge for Neurologists. Clin Neurol Neurosci. 2020;4(3):61-65. doi: 10.11648/j.cnn.20200403.14
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Download@article{10.11648/j.cnn.20200403.14,
author = {Rafaela Magalhães Britto Pacheco de Moraes and Fernando José de Souza and João Fellipe Santos Tatsch and Livia Souza Santos and José Furtado Alves Junior and Maria Sheila Guimarães Rocha},
title = {Orthostatic Jaw Tremor, a Diagnostic Challenge for Neurologists},
journal = {Clinical Neurology and Neuroscience},
volume = {4},
number = {3},
pages = {61-65},
doi = {10.11648/j.cnn.20200403.14},
url = {https://doi.org/10.11648/j.cnn.20200403.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20200403.14},
abstract = {Jaw tremor is usually associated with tremor or other abnormal involuntary movements affecting additional body parts, but isolated jaw tremor is a rare clinical presentation. A 40-year-old man presented with history of paroxysmal jaw tremor for 3 years with no other neurological symptoms, psychiatric conditions, or a family history of neurological disorders. The tremor occurred only in the resting jaw position, with 10 episodes per day on an average, and lasted from 10 minutes to hours. It disappeared with any voluntary activation of the masseter muscle and did not change (in amplitude or frequency) with distraction maneuvers. The remainder of neurologic examination was unremarkable. The patient underwent extensive testing, including contrast-enhanced brain magnetic resonance imaging, blood tests and neuropsychiatric evaluation by two different neuropsychiatrists which failed to reveal the underlying cause. The needle electromyography examination revealed involuntary, intermittent, and synchronized muscular contractions in both masseter muscles, at a frequency of 13 to 14 Hz. No changes were discovered in the other muscles. He was treated with propranolol, primidone, valproic acid, diazepam, and amitriptyline, but the response was not significant. Injection of 25 units of botulinum toxin type A in the masseter muscle on both sides of the fac was effective five days after the injection. No adverse effects or masseter weakness were observed.},
year = {2020}
}
TY - JOUR T1 - Orthostatic Jaw Tremor, a Diagnostic Challenge for Neurologists AU - Rafaela Magalhães Britto Pacheco de Moraes AU - Fernando José de Souza AU - João Fellipe Santos Tatsch AU - Livia Souza Santos AU - José Furtado Alves Junior AU - Maria Sheila Guimarães Rocha Y1 - 2020/08/31 PY - 2020 N1 - https://doi.org/10.11648/j.cnn.20200403.14 DO - 10.11648/j.cnn.20200403.14 T2 - Clinical Neurology and Neuroscience JF - Clinical Neurology and Neuroscience JO - Clinical Neurology and Neuroscience SP - 61 EP - 65 PB - Science Publishing Group SN - 2578-8930 UR - https://doi.org/10.11648/j.cnn.20200403.14 AB - Jaw tremor is usually associated with tremor or other abnormal involuntary movements affecting additional body parts, but isolated jaw tremor is a rare clinical presentation. A 40-year-old man presented with history of paroxysmal jaw tremor for 3 years with no other neurological symptoms, psychiatric conditions, or a family history of neurological disorders. The tremor occurred only in the resting jaw position, with 10 episodes per day on an average, and lasted from 10 minutes to hours. It disappeared with any voluntary activation of the masseter muscle and did not change (in amplitude or frequency) with distraction maneuvers. The remainder of neurologic examination was unremarkable. The patient underwent extensive testing, including contrast-enhanced brain magnetic resonance imaging, blood tests and neuropsychiatric evaluation by two different neuropsychiatrists which failed to reveal the underlying cause. The needle electromyography examination revealed involuntary, intermittent, and synchronized muscular contractions in both masseter muscles, at a frequency of 13 to 14 Hz. No changes were discovered in the other muscles. He was treated with propranolol, primidone, valproic acid, diazepam, and amitriptyline, but the response was not significant. Injection of 25 units of botulinum toxin type A in the masseter muscle on both sides of the fac was effective five days after the injection. No adverse effects or masseter weakness were observed. VL - 4 IS - 3 ER -
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