Botulinum toxin treatment of lingual dystonia, oromandibular dystonia and bruxism-A review and update

Using Medline and Scopus search engines (up to January 1st, 2025), we identified 12 clinical reports on botulinum neurotoxinA therapy for lingual dystonia, 17 reports for oromandibular dystonia and 6 clinical trials on bruxism. In a majority of these studies, the investigated toxin was onabotulinumtoxinA. In most of these studies, local botulinum neurotoxin injections into the affected muscle(s) reduced involuntary movements and improved pain - the latter was specifically the case in oromandibular dystonia and bruxism. Dysphagia was the main concerning side effect after botulinum neurotoxin therapy; it was reported in 5 trials in lingual dystonia and 5 trials in oromandibular dystonia. Several studies had incomplete information i.e., lacked important information such as the type of toxin used, presence or absence of side effects and the effect of injected toxin on the quality of life. Controlled and blinded studies are needed to discern the true efficacy of botulinum toxin therapy in lingual dystonia, oromandibular dystonia and bruxism as well as discerning frequency and severity of post-injection short and long-term side effects.