Orofacial Dystonia with Lower Facial and Platysma Dystonia

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Part of the Current Clinical Neurology book series (CCNEU)


Lower facial dystonia produces abnormal movements and postures of the lower face which are often associated with contractions of the platysma. Similar to other facial dystonias which cause puckering or pursing of the lips, speech often activates the movements thereby causing dysarthria. Lower facial dystonia is often accompanied by anterocollis. Differential diagnosis is similar to other forms of orofacial dystonia (see Chap. 47). Treatment is usually limited to injections of botulinum toxin into the affected muscles. Care must be exercised with lower facial injections in order to avoid lip closure weakness which may produce drooling.


Public Health Internal Medicine Differential Diagnosis Botulinum Toxin Lower Face 
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Supplementary material

OD w. lower facial & platysma dystonia.mp4 (MP4 4,094KB)

While speaking, the patient displays downward contractions of the corners of his mouth and active contractions of the platysma.


  1. 1.
    Jankovic J, Ford J. Blepharospasm and orofacial-cervical dystonia: clinical and pharmacological findings in 100 patients. Ann Neurol. 1983;13:402–11.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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