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J Oral Maxillofac Surg. 2014 Jul;72(7):1327.e1-4. doi: 10.1016/j.joms.2014.02.016. Epub 2014 Feb 16.

Self-mutilation of the lower lip in a child with dystonia secondary to megalencephalic leukoencephalopathy treated with botox injections: a case report.

Author information

1
Department Chair, Oral and Maxollifacial Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY.
2
Resident, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY. Electronic address: james_roger@urmc.rochester.edu.
3
Private Practice, Pennsylvania.
4
Associate Professor, University of Minnesota School of Dentistry, Minneapolis, MN.

Abstract

PURPOSE:

We report the case of a 10-year old boy who had been diagnosed with megalencephalic leukoencephalopathy several years earlier. Because of the patient's oral dystonic activity, a traumatic, nonhealing, chronic ulcer had developed on his lower lip.

MATERIALS AND METHODS:

Botox-A was injected into the mentalis, orbicularis oris, and bilateral masseter muscles.

RESULTS:

The patient showed decreased dystonia and gradual complete healing of the traumatic ulcer of the lower lip.

CONCLUSIONS:

The treatment of patients with self-mutilation to the lips will often be difficult. Traditionally, patients have been treated with various medications, oral appliances, and even tooth extraction. The results of the present case report suggest that Botox should be considered as a possible first-line strategy, along with oral appliances.

PMID:
24679955
DOI:
10.1016/j.joms.2014.02.016
[Indexed for MEDLINE]

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