- Not to be confused with Meigs syndrome
is a type of dystonia
. It is also known as oral facial dystonia
. It is actually a combination of two forms of dystonia, blepharospasm and oromandibular dystonia (OMD).
When OMD is combined with Blepharospasm, it may be referred to as Meige’s Syndrome named after Henry Meige, the French neurologist who first described the symptoms in detail in 1910.The symptoms usually begin between the ages of 40 and 70 years old and appear to be more common in women than in men. The combination of upper and lower dystonia is sometimes called cranial-cervical dystonia.
- difficulty opening the mouth (trismus)
- clenching or grinding of the teeth (bruxism)
- spasms of jaw opening
- sideways deviation or protrusion of the jaw
- lip tightening and pursing
- drawing back (retraction) of the corners of the mouth
- deviation or protrusion of the tongue.
- jaw pain
- difficulties eating and drinking
- difficulties speaking (dysarthria).
- uncontrollable squinting/closing of eyes
- light sensitivity(photophobic)
- squinting/eyes closing during speech
- uncontrollable eyes closing shut(rare instances completely causing blindness)
In addition, in some patients, the dystonic spasms may sometimes be provoked by certain activities, such as talking, chewing, or biting. As discussed earlier, particular activities or sensory tricks may sometimes temporarily alleviate OMD symptoms, including chewing gum, talking, placing a toothpick in the mouth, lightly touching the lips or chin, or applying pressure beneath the chin.
A few upper and lower dystonia types
Blepharo means "eyelid". Spasm means "uncontrolled muscle contraction". The term blepharospasm ['blef-a-ro-spaz-m] can be applied to any abnormal blinking or eyelid tic or twitch resulting from any cause, ranging from dry eyes to Tourette's syndrome to tardive dyskinesia. The blepharospasm referred to here is officially called benign essential blepharospasm (BEB) to distinguish it from the less serious secondary blinking disorders. "Benign" indicates the condition is not life threatening, and "essential" is a medical term meaning "of unknown cause". It is both a cranial and a focal dystonia. Cranial refers to the head and focal indicates confinement to one part. The word dystonia describes abnormal involuntary sustained muscle contractions and spasms. Patients with blepharospasm have normal eyes. The visual disturbance is due solely to the forced closure of the eyelids.
Oromandibular dystonia (OMD) is a form of focal dystonia that affects varying areas of the head and neck including the lower face, jaw, tongue and larynx. The spasms may cause the mouth to pull open, shut tight, or move repetitively. Speech and swallowing may be distorted. It is often associated with dystonia of the cervical muscles (Spasmodic Torticollis), eyelids (Blepharospasm), or larynx (Spasmodic Dysphonia).
In patients with OMD, involuntary contractions may involve the muscles used for chewing (masticatory muscles). These may include the thick muscle in the cheek that closes the jaw (buccinator muscles) and the broad muscle that draws back the lower jaw and closes the mouth (temporalis muscle). Some patients may also experience involuntary contractions of the wide muscle at the side of the neck that close the jaws. This muscle draws down the corner of the mouth and lower lip (platysmal muscles) or other muscle groups.
Meige's is commonly misdiagnosed and most doctors will have not seen this condtion before. Usually a neurologist who specializes in movement disorders can detect Meige's. The is no way to detect Meige's by blood test or MRI or CT scans. OMD by itself, maybe misdiagnosed as TMJ.
The main symptoms involve involuntary blinking
thrusting. Also some may experience excessive tongue protrusion, squinting, light sensitivty, muddled speech, uncontrollable contraction of the platysma muscle. Some Meige's patients also have "laryngeal dystonia" (spasms of the larynx
). While the blepharospasm is embarrassing in social situations. Oromandibular dystonia can affect speech, making it difficult to carry the simplest conversations. Which leads to difficulty professionally as well as in the personal life. Some might find it easier uttering only a few words to suppress the speech problems. Which lends itself to seeming as if you're not part of a conversation and to social repression.
The condition tends to affect women more frequently than men.
There is no cure for Meige's Syndrome, nor can it be prevented, except in cases where it is caused by medication. Although palliative
treatments are available, such as Botox
injections. In some instances, acupuncutre has been known to help. Even though it is a form of alternative medicine, there have been some reports of acupuncture minimizing the effects of Meige's
It is named for Henri Meige