Clinical Reasoning: a 57-year-old man with jaw spasms

Neurology. 2013 Mar 5;80(10):e104-7. doi: 10.1212/WNL.0b013e318285c14a.

Abstract

A 57-year-old man presented with spasms of his left jaw. Two years prior, he had developed left-sided facial numbness followed by development of left-sided shock-like pain and then involuntary and repetitive movements of the jaw-closing muscles. Jaw muscle contractions were episodic, interfered with chewing and talking, and led to frequent tongue biting. Individual spasms varied from seconds to minutes and he reported that function in between episodes was normal, although his wife felt he spoke with reduced mouth opening. He sometimes awoke with a bloody tongue, suggesting that contractions occurred during waking and sleep. He had no history of premonitory sensation or relief associated with the spasms. He reported no difficulty swallowing.

Publication types

  • Case Reports
  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Adrenergic Uptake Inhibitors / therapeutic use
  • Amines / therapeutic use
  • Anticonvulsants / therapeutic use
  • Brain Neoplasms / complications*
  • Brain Neoplasms / pathology
  • Cyclohexanecarboxylic Acids / therapeutic use
  • Duloxetine Hydrochloride
  • Facial Muscles*
  • Gabapentin
  • Hemangioma / complications*
  • Hemangioma / pathology
  • Humans
  • Jaw*
  • Male
  • Middle Aged
  • Spasm / drug therapy
  • Spasm / etiology*
  • Thiophenes / therapeutic use
  • gamma-Aminobutyric Acid / therapeutic use

Substances

  • Adrenergic Uptake Inhibitors
  • Amines
  • Anticonvulsants
  • Cyclohexanecarboxylic Acids
  • Thiophenes
  • gamma-Aminobutyric Acid
  • Gabapentin
  • Duloxetine Hydrochloride