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Botulinum Toxin A in Poststroke Oromandibular Dystonia: Case Reports
Elena Brevi1, Davide Villa2, Davide Dalla Costa3
1School of Specialization in Physical Therapy and Rehabilitative Medicine, The University of Milan, Milan, Italy, unimi.it.
Case Reports in Neurological Medicine
|February 11, 2026
Summary
Botulinum toxin A (BoNT-A) offers a safe and effective long-term treatment for poststroke oromandibular dystonia (OMD). This case series demonstrates sustained improvement for up to 10 years in patients with jaw-closing OMD following pontine hemorrhage.
Area of Science:
- Neurology
- Ophthalmology
- Movement Disorders
Background:
- Poststroke oromandibular dystonia (OMD) is a rare and difficult-to-treat condition.
- Limited literature exists on the long-term efficacy of Botulinum toxin A (BoNT-A) for OMD after hemorrhagic stroke.
Purpose of the Study:
- To evaluate the long-term safety and efficacy of BoNT-A for poststroke jaw-closing OMD (JC-OMD).
Main Methods:
- A case series of three patients with pontine hemorrhage-induced JC-OMD.
- Ultrasound-guided BoNT-A administration.
- Follow-up for up to 10 years.
Main Results:
- All three patients experienced clinical improvement within 4 weeks of BoNT-A treatment.
- The positive effects were sustained for up to 10 years.
- No adverse events were reported during the follow-up period.
Conclusions:
- Poststroke OMD is an underrecognized condition.
- BoNT-A demonstrates safety and efficacy for long-term management of poststroke JC-OMD.
- Further research is needed to understand mechanisms and standardize treatments.
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