Effect of Botulinum Toxin A on Trismus after Traumatic Brain Injury: A case report.

, Kang, Youn Joo; , Oh, Jun Ho; , Kim, Ji Sung; , Shin, Sung Hun; , Park, Kyung Tae

Case Report

Journal of the Korean Academy of Rehabilitation Medicine 2008;32(4):456-459.

Kang, Youn Joo , Oh, Jun Ho , Kim, Ji Sung , Shin, Sung Hun , Park, Kyung Tae

¹Department of Rehabilitation, Eulji Hospital, Eulji University School of Medicine, Korea.
²Department of Rehabilitation, Myonji Hospital, Kwandong University College of Medicine, Korea. holygive@naver.com

뇌손상 환자에서 입벌림 장애에 대한 보툴리눔 독소 A의 효과 -증례 보고-

강윤주, 오준호¹, 김지성¹, 신성헌¹, 박경태

을지의과대학교 재활의학교실, ¹관동대학교 의과대학 명지병원 재활의학교실

Abstract

We report a case of severe trismus following traumatic brain injury (TBI), which was treated successfully with botulinum toxin A. Its effect evidenced long-term resolution, for over one year. A 36 year-old man with a multifocal intracranial hemorrhage was admitted for quadriplegia with dysphagia and trismus. During ten months, a nasogastric tube was placed for feeding after TBI, and at that time his upper- to-lower interincisal distance was only 1.2 cm upon voluntary mouth opening. Botulinum toxin A 450 U (Dysport^Ⱂ) was injected into both masseter, medial pterygoid and left temporalis muscles under electromyographic guidance. The interincisal distance began to improve one week after injection. He successfully underwent percutaneous endoscopic gastrostomy, dysphagia rehabilitation therapy, and dental prosthesis. More than one month after injection, oral feeding proved possible. After 1 year his interincisal distance was maintained at 2.9 cm. (J Korean Acad Rehab Med 2008; 32: 456-459)

Key Words: Trismus, Brain injury, Botulinum toxin