Unusual cause of trismus – a case report

Introduction  Trismus is often a cardinal symptom of extensive inflammatory and also tumorous lesions of the oral cavity and the oropharynx, which are associated with involvement of the pterygoid muscles. Much less often, diseases are causal that can be found outside and independently of this, but which are of considerable clinical relevance in terms of differential diagnosis.

Case report We report on a 65-year-old female patient who presented in our emergency ward with the cardinal symptom of trismus. This symptom was accompanied by bitemporal headache and a significantly reduced general condition. Clinically, apart from the trismus, the ENT examination was without pathological findings. Laboratory chemistry showed clearly increased leukocytes, CRP and erythrocyte sedimentation rate and thus the suspicion of a giant cell arteritis. With the help of modern duplex sonography, temporal arteritis could be diagnosed with certainty. The traditional histological confirmation of the diagnosis could be omitted. Therapy with high-dose cortisone led to a rapid and complete relief of symptoms.

Conclusion The symptom of trismus is most often associated with inflammatory and tumorous changes in the oral cavity and oropharynx. If the clinical findings are discrepant, the presence of a systemic rheumatic disease must be considered. In the case presented by us, laboratory and interdisciplinary neurological diagnostics were able to quickly and unequivocally confirm temporal arteritis. The traditional histological confirmation of the diagnosis is only of limited importance today due to modern ultrasound diagnosis.

Conflict of Interest

The author declares that there is no conflict of interest.

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Artikel online veröffentlicht:
13. Juni 2022