Health A-Z

Oral-facial dyskinesia is characterized by involuntary, repetitive movements affecting the face, mouth, and sometimes the jaw. Symptoms may include.

1. Involuntary Facial Movements: Repetitive, uncontrollable movements of the mouth, lips, tongue, or jaw.
2. Grimacing: Unintentional facial expressions, such as grimacing or puckering of the lips.
3. Tongue Thrusting: Involuntary protrusion or movements of the tongue.
4. Chewing or Smacking Movements: Repetitive chewing or smacking motions of the mouth.
5. Facial Tics: Sudden, brief, repetitive movements or twitches of facial muscles.
6. Speech Diffculties: Difficulties speaking clearly o articulating words due to involuntary movements of the mouth or tongue.

The treatment plan for oral-facial dyskinesia aims to manage symptoms and improve quality of life. Treatment options include:

1. Medication Management:

   • Adjusting or Discontinuing Causative Medications:
     • Gradual reduction or discontinuation of offending medications (e.g., antipsychotics).
     • Switching to alternative medications with a lower risk of dyskinesia.
   • Medications to Treat Symptoms:
     • Tetrabenazine and deutetrabenazine: VMAT2 inhibitors that reduce dopamine storage and release.
     • Clonazepam: A benzodiazepine that can help reduce muscle movements.
     • Botulinum Toxin Injections: Targeted injections to relax specific facial muscles.

2. Behavioral and Supportive Therapies:

   • Speech and Language Therapy: To address communication difficulties.
   • Occupational Therapy: To improve daily functioning and manage specific difficulties related to dyskinesia.
   • Physical Therapy: To enhance overall motor control and coordination.

3. Psychosocial Support:

   • Counseling and Support Groups: To provide emotional support and coping strategies.
   • Education: For patients and caregivers about the condition and management strategies.

4. Lifestyle Modifications:

   • Avoiding stress and fatigue, which can exacerbate symptoms.
   • Implementing relaxation techniques such as meditation or yoga.

5. Follow-Up and Monitoring:

   • Regular follow-up appointments to monitor symptoms and adjust treatments as necessary.
   • Ongoing assessment with tools like AIMS to track progress and response to treatment.

Diagnosis of oral-facial dyskinesia involves several steps, including clinical evaluation and, in some cases, specific tests to rule out other conditions. The diagnostic process includes:

1. Medical History and Physical Examination:

   • Detailed history of symptoms onset and progression.
   • Review of medications (especially antipsychotics and other dopamine antagonists) that might cause tardive dyskinesia.
   • Assessment of neurological and psychiatric status.

2. Neurological Examination:

   • Detailed examination of cranial nerves, motor function, and coordination.
   • Observation of involuntary movements and their patterns.

3. Rating Scales:

   • Use of standardized scales such as the Abnormal Involuntary Movement Scale (AIMS) to quantify the severity and impact of dyskinesia.

4. Laboratory Tests:

   • Blood tests to rule out metabolic or electrolyte imbalances.
   • Imaging studies (e.g., MRI or CT scan) to rule out structural brain abnormalities.

5. Specialized Testing:

   • Genetic testing if hereditary movement disorders are suspected.
   • Electroencephalography (EEG) if there is suspicion of seizure-related movements.