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Breathing issue, can't lift head without mouth open. Help?

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Patient's Query

Hello doctor,

I have some problems to breathe, and my head goes side to side. I was wondering if this is a normal head shape? And not be able to lift it without having the mouth completely open, so the jaw hurts. Please help.

Hello,

Welcome to icliniq.com. I saw the pictures, and it seems you have action induced focal dystonia (attachment removed to protect patient identity). Please tell me how long you have these symptoms, and how does it come and get settled? Does it persist for some time? Again do you have any more stiffness elsewhere in the body? You can get an magnetic resonance (MR) brain, as well as serum copper or ceruloplasmin levels, done. You try a course of L-Dopa 25 mg tid (thrice a day) in the meantime. If not alleviating, you can see a movement disorder specialist. The probable causes include idiopathic. But there are many more tests to rule out secondary causes. Genetic tests are available. The investigations to be done are MR brain, copper, and ceruloplasmin. The differential diagnosis is secondary dystonia. The probable diagnosis is focal action dystonia? dihydroxy phenylalanine (DOPA) responsive. Treatment plan include L-Dopa for a period of six months. Preventive measure is to see the progression of disability.

Patient's Query

Thank you doctor,

So you believe this is a normal head? Because I have never been able to keep my head still since I was a child. And it happens as soon as I open my mouth. My head falls back as soon as I open the mouth. I feel it in the neck. May you cannot see it. But I can feel when I open my mouth, and my head falls backward.

Hello,

Welcome back to icliniq.com. Jaw head dyskinesia and again a sort of dystonic trigger movement only. As long as it does not affect your day to day routine, it can be left alone as habitual. A trial L-Dopa (Sinemet) to see the response is worthwhile. The probable cause is idiopathic. The differential diagnosis is habitual spasms. The probable diagnosis is dystonia of focal. Treatment plan include Trial Sinemet 25 mg tid (thrice a day) for a month.

Medically reviewed byDr. Nithila. A

Published At September 18, 2019
Reviewed AtJuly 16, 2024

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