Three cases of focal embouchure dystonia: classifications and successful therapy using a dental splint

Eur Neurol. 2011;66(2):85-90. doi: 10.1159/000329578. Epub 2011 Aug 12.


Background: Focal embouchure dystonia (FED) is a type of task-specific dystonia affecting wind instrument players, and it frequently ends their professional careers. The results of the treatments of FED in the reported literature are disappointing.

Objective: We report 3 patients with FED who were brass instrument players. In 1 patient, we evaluated the usefulness of a dental splint.

Methods and results: Patient 1 was a 28-year-old trumpeter who was suffering from an intermittent tremor of the lower jaw. Following the usage of a dental splint, her symptoms disappeared completely. Patient 2 was a 29-year-old horn player with atonia of the lower facial muscles. In this case, medication with various drugs brought no benefit, and he ended his career. Patient 3 was a 43-year-old trombone player who suffered involuntary contractions and relaxation of the perioral muscles along with clumsiness of tongue movement. Extraction of double teeth and long-term cessation of playing for 20 years did not bring any positive effects.

Conclusion: We propose that FED can be categorized into three subgroups according to masticatory, facial and lingual types, and that the dental splint might be a useful therapeutic strategy for the masticatory type of FED.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dystonic Disorders / classification*
  • Dystonic Disorders / therapy*
  • Female
  • Humans
  • Male
  • Splints*
  • Tooth*