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April 18, 1977

Involuntary Jaw Movements in Elderly Patients

Author Affiliations

Southern Illinois University School of Medicine Springfield

JAMA. 1977;237(16):1690. doi:10.1001/jama.1977.03270430032003

To the Editor.—  We believe the reply by Dr Laskin in the QUESTIONS AND ANSWERS section (236:2447, 1976) regarding cause and treatment of involuntary chewing-like movements in geriatric patients contains errors and misconceptions. Dr Laskin implies that the most common cause for this condition is parkinsonism. While patients with Parkinson disease occasionally have involuntary movements of the face and mouth other than rhythmic tremor, this is uncommon. It is true that during the epidemic of von Economo encephalitis, afflicted patients commonly experienced such involuntary movements during the active stages of the disease. It is also true that levodopa therapy frequently produces oral dyskinesias in patients being treated for Parkinson disease.Dr Laskin then goes on to say that "the next most common condition is orofacial dyskinesia," and that "this extrapyramidal disorder usually is a sequela of encephalitis." We do not agree that this is the case. In fact, if one