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Task-specific oromandibular dystonia secondary to chewing Khat (Catha edulis)- A series of 35 cases
Pettarusp Murzban Wadia1, Vaibhav Mathur1, Prashanth Lingappa Kukkle2
1Movement Disorder Clinic, Department of Neurology, Jaslok Hospital and Research Centre, Mumbai, India.
Background:
The leaves of "Khat" (Catha edulis), an indigenous shrub of Yemen and Arabian Peninsula are habitually chewed by the inhabitants for psychostimulant properties.
Objective:
To describe a unique task specific Oro-mandibular dystonia (OMD) in Yemenese men, with a temporal association with chewing "Khat".
Methods:
Multicentric, retrospective analysis (2009-2020) of patients with OMD associated with "Khat" chewing, evaluating clinical features and response to Onabotulinum toxin A.
Results:
35 Yemenese men with a negative family history, normal neuroimaging mean age of 44.31(±3.21) years and prolonged (20.31 ± 3.27 years) history of chewing Khat, around 5.16(±0.80) hours/day presented with OMD-20 jaw opening, 13 jaw closing and 2 mixed affecting chewing (n = 6), speech (n = 3), or both (n = 26). Additional lingual dystonia was seen in five.
Conclusions:
Chewing of khat is a repetitive task involving the jaw musculature and may be one of the causative factors of this task specific OMD. Recognition can prevent disability in these regions.
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