Targeted Myofascial Release in Oromandibular Dystonia: A Case Report on Non-Invasive Tremor Reduction and Functional Recovery

Abstract

Introduction

Oromandibular dystonia (OMD) is a rare, disabling movement disorder causing involuntary jaw and neck tremors. Traditional treatments, such as botulinum toxin (BTX) injections, can have side effects or limited efficacy. This case report aims to explore the effects of a non-invasive, multimodal intervention, including targeted myofascial release (MFR), on tremor severity, balance, gait, and functional independence in a patient with OMD.

Case Presentation

The patient, a 65-year-old female, presented with severe jaw tremors, impaired balance, and functional limitations in daily activities. Her symptoms were assessed pre-intervention using standardized tools, including the Berg Balance Scale (BBS), Tinetti Assessment Tool (TAT), Tremor Rating Grid (TRG), Gait Assessment Instrument (GAIT), Bristol Activities of Daily Living Scale (BADLS), Barthel Index (BI), and Katz Index (KI).

Intervention

The patient underwent 12 sessions over 4 weeks of targeted MFR, combined with core stabilization, jaw exercises, and sensory stimulation. Treatment progressed in three phases: tone control and trunk preparation, direct neck and jaw MFR, and functional stabilization with jaw resistance and speech exercises.

Outcomes

The intervention led to substantial improvements in tremor severity (TRG: 16→5), balance (BBS: 4→27), gait (GAIT: 6→23), and functional independence (BADLS: 21→11; Barthel: 30→70; Katz: 3→6).

Conclusion

This case demonstrates that targeted MFR is a safe, non-invasive intervention that can substantially improve tremor, balance, gait, and functional independence in OMD. These findings highlight the novelty and clinical relevance of the approach and support the need for larger controlled studies.