A case of fibromyalgia showing a variety of orofacial manifestations including a disturbance of mouth opening

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Fibromyalgia (FM) is characterized by chronic pain over the entire body resulting from an unknown cause. The patients' quality of life is often poor due to chronic fatigue and multiple tenderness. The disease is also complicated by a variety of orofacial manifestations, such as temporomandibular disorders, dry mouth and taste disorders. We herein report a 62-year-old female with trismus who was diagnosed with FM, and who improved after medical therapy. The patient had experienced domestic stress, and developed numbness of the left side of face after being beaten by husband five years earlier. Three years previously, she had noticed trismus, and lip and left eyelid movement disorders. She also suffered from dry mouth and taste disorders, and was referred to our department. She complained of fatigue and anorexia. A physical examination revealed bilateral tenderness of the temporal, digastric, sternocleidomastoid, trapezius, and medial pterygoid muscles. Trismus was also observed, and the range of maximum mouth opening was 31 mm. The patient was referred to a rheumatologist due to a suspicion of systemic disease. A clinical examination revealed chronic and wide-spread pain in combination with tenderness at 17 of the 18 specific tender points. Based on the American College of Rheumatology 1990 criteria, a diagnosis of FM was confirmed. The patient's chronic pain in the whole body decreased after the oral administration of pregabalin (Lyrica®). The tenderness of the masticatory and neck muscles also decreased, and the maximum mouth opening increased to 42 mm. The treatment continued for one year, and her symptoms have been stable. Although this disease is often associated with manifestations in the orofacial region, its recognition by dentists is low. Therefore, dentists should pay attention to this disease, and if necessary, should promptly refer the patient to a specialist to achieve an improvement of the symptoms.
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A case of fibromyalgia showing a variety of orofacial manifestations including a disturbance of mouth opening

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