Hayashi Koji, Maeda Akiho, Suzuki Asuka, Nakaya Yuka, Sato Mamiko, Takaku Naoko, Miura Toyoaki, Kobayashi Yasutaka
Department of Rehabilitation Medicine, Fukui General Hospital, Fukui, JPN.
Department of Neurology, University of Fukui, Fukui, JPN.
Cureus. 2025 Mar 28;17(3):e81345. doi: 10.7759/cureus.81345. eCollection 2025 Mar.
This report presents two cases of temporomandibular joint (TMJ) dislocation in patients with L-dopa-responsive Parkinsonism, highlighting an underrecognized complication of the disease. Both patients, classified as Hoehn-Yahr stage IV, exhibited typical Parkinsonism symptoms, such as tremors, rigidity, and gait disturbances. TMJ dislocations occurred in both patients during events involving wide mouth opening, one during breakfast and the other while yawning. The underlying pathophysiology remains unclear but may be related to Parkinsonism-associated muscle rigidity or involuntary orofacial movements. Manual reduction was performed in both cases, though difficulties were encountered due to increased muscle tone. These cases underscore the importance of early recognition and proactive management of TMJ dysfunction in Parkinsonism patients, especially in cases of advanced disease. Future studies should explore preventative strategies and optimal management techniques to improve patient outcomes. Accumulating data from similar cases will be essential for developing more effective management strategies for TMJ dysfunction in patients with Parkinsonism.
本报告介绍了两例左旋多巴反应性帕金森病患者发生颞下颌关节(TMJ)脱位的病例,突出了该疾病一种未被充分认识的并发症。两名患者均被归类为Hoehn-Yahr IV期,表现出典型的帕金森病症状,如震颤、僵硬和步态障碍。两名患者均在大口张开的活动中发生TMJ脱位,一例发生在早餐时,另一例在打哈欠时。潜在的病理生理学尚不清楚,但可能与帕金森病相关的肌肉僵硬或不自主的口面部运动有关。两例均进行了手法复位,不过由于肌张力增加遇到了困难。这些病例强调了早期识别和积极处理帕金森病患者TMJ功能障碍的重要性,尤其是在疾病晚期。未来的研究应探索预防策略和最佳处理技术以改善患者预后。积累类似病例的数据对于制定更有效的帕金森病患者TMJ功能障碍管理策略至关重要。