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E Devenney

POSTER PRESENTATION Open Access
Bilateral jaw dislocation following botulinim toxin
type A treatment for chronic migraine
RB Forbes*, E Devenney
From The European Headache and Migraine Trust International Congress
London, UK. 20-23 September 2012
Background
Botulinim Toxin Type A is a licenced treatment for
chronic migraine. We describe a case of bilateral jaw dis-
location which occurred following Botulinim Toxin
Injection. Case Description The patient is a 46 year old
lady with a 25 year history of chronic migraine and no
previous history of joint dislocations. She was injected
following the 155 unit fixed-dose, fixed site protocol with
no immediate complications. 8 days later the patient
developed acute bilateral jaw pain and an inability to
close the mouth. An x-ray confirmed bilateral temporo-
mandibular joint dislocations and this was reduced the
following day by an oral surgeon. There has been no
recurrence, however she continues to complain of jaw
pain. As her initial injection was associated with an
improvement in headache, she consented to further
treatment on the basis that the temporalis muscle was
not injected. To date there has been no recurrent
dislocation.
Conclusion
We believe that injection of the temporalis muscle in
this patient predisposed to bilateral temporomandibular
joint dislocation. To our knowledge this has not pre-
viously been reported. Regulatory authorities have been
notified but treating neurologists need to be aware of
this rare occurence.
Published: 21 February 2013
doi:10.1186/1129-2377-14-S1-P211
Cite this article as: Forbes and Devenney: Bilateral jaw dislocation
following botulinim toxin type A treatment for chronic migraine. The
Journal of Headache and Pain 2013 14(Suppl 1):P211.
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Craigavon Area Hospital, UK
Forbes and Devenney The Journal of Headache and Pain 2013, 14(Suppl 1):P211
http://www.thejournalofheadacheandpain.com/content/14/S1/P211
© 2013 Forbes and Devenney; licensee Springer. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


Bilateral jaw dislocation following botulinim toxin type A treatment for chronic migraine

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