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Merrill RL, Goodman D, Chamani G, Shabani M. A case of conversion disorder presenting as chronic trismus. SPECIAL CARE IN DENTISTRY 2024; 44:130-135. [PMID: 37026440 DOI: 10.1111/scd.12860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/15/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023]
Abstract
Trismus can be the symptom of several diseases. For the most part, the inability to open the mouth is due to an articular disorder but occasionally, the cause may be extra-articular. In this case, being reported, non-articular hysterical trismus caused the jaw to lock in an 11-year-old boy for 3 months. During this period the jaw was completely locked and the locking was associated with moderate to severe pain. After three sessions of therapy the patient was able to open his mouth 33 mm and his eating was back to normal. Conversion disorders often present with dramatic physical presentation including trismus and jaw lock. This report highlights the importance of complete history taking and a thorough clinical examination to make a correct diagnosis in a patient with trismus.
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Affiliation(s)
| | - Donald Goodman
- Clinician, UCLA Orofacial Pain Department, Los Angele, USA
| | - Goli Chamani
- Department of Oral Medicine, Orofacial Pain Clinic, Kerman School of Dentistry, Kerman, Iran
| | - Mohammad Shabani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
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Perina V, Szaraz D, Harazim H, Urik M, Klabusayova E. Paediatric Deep Neck Infection—The Risk of Needing Intensive Care. CHILDREN 2022; 9:children9070979. [PMID: 35883963 PMCID: PMC9315740 DOI: 10.3390/children9070979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/19/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022]
Abstract
Deep neck infections are potentially dangerous complications of upper respiratory tract or odontogenic infections. The pathophysiology, clinical presentation, and potential spreading depend on the complex anatomy of the neck fascia. These infections can lead to severe pathological conditions, such as mediastinitis, sepsis, and especially airway impairment with difficult management. Because of the risk of life-threatening emergency situations and the possible impacts on the overall health status of affected children, their early recognition is of utmost importance. Torticollis, drooling, and stridor are the most common signs of advancing disease. Children presenting with these symptoms should be admitted to the paediatric intensive care unit for vital function monitoring, where the airway could be readily secured if function is compromised.
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Affiliation(s)
- Vojtech Perina
- Department of Oral and Maxillofacial Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic; (V.P.); (D.S.)
| | - David Szaraz
- Department of Oral and Maxillofacial Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic; (V.P.); (D.S.)
| | - Hana Harazim
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic;
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Milan Urik
- Department of Paediatric Otorhinolaryngology, University Hospital Brno, Faculty of Medicine, Masaryk University, Cernopolni 9, 662 63 Brno, Czech Republic;
| | - Eva Klabusayova
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic;
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
- Correspondence: ; Tel.: +420-532-234-693
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A 17-Year-old With Trismus and Neck Pain. Pediatr Infect Dis J 2021; 40:1151-1152. [PMID: 33742612 DOI: 10.1097/inf.0000000000003132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Infant developmental profile of Crisponi syndrome due to compound heterozygosity for CRLF1 deletion. Clin Dysmorphol 2021; 29:141-143. [PMID: 32433043 DOI: 10.1097/mcd.0000000000000325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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An adolescent with limited mouth opening. J Paediatr Child Health 2016; 52:1118. [PMID: 27989002 DOI: 10.1111/jpc.2_13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 01/17/2016] [Accepted: 02/04/2016] [Indexed: 11/28/2022]
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Hong CJ, Caulley L, Kohlert S, Graham GE, McMillan HJ, Michaud J, Vaccani JP. Congenital Trismus From Brainstem Dysgenesis: Case Report and Review of Literature. Pediatrics 2016; 138:peds.2015-4605. [PMID: 27255150 DOI: 10.1542/peds.2015-4605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2016] [Indexed: 11/24/2022] Open
Abstract
Trismus refers to any condition inducing limited mouth opening and may present as a result of acquired or congenital pathology. We present the case of a newborn who presented with severe, congenital trismus due to brainstem dysgenesis. We describe the course of his investigations, and a multidisciplinary approach to the management of his care and follow-up. To our knowledge, this is one of the earliest reported cases of congenital trismus attributable to brainstem dysgenesis. A literature review was conducted to provide an overview of the differential pathogenesis as it presents in congenital cases and discuss the complexity of managing congenital trismus due to brainstem dysgenesis in a neonate and infant.
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Affiliation(s)
- Chris J Hong
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lisa Caulley
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada; and
| | - Scott Kohlert
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada; and
| | | | | | | | - Jean-Philippe Vaccani
- Otolaryngology-Head and Neck Surgery, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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