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Task Specific Oromandibular dystonia due to Shisha (Hookah) Smoking- “Shisha Dystonia”

S. Mittal, H. Yu, P. Krystkowiak (Abu Dhabi, United Arab Emirates)

Meeting: 2022 International Congress

Abstract Number: 550

Keywords: Botulinum toxin: Clinical applications: dystonia, Dystonia: Clinical features, Orobuccolingual dyskinesia

Category: Dystonia: Epidemiology, Genetics, Phenomenology

Objective: To report an unusual case of oromandibular dystonia due to repeated task of smoking shisha/hookah.

Background: Focal task-specific dystonia is common in men, aged 30s-60’s, associated with repeated task such as playing musical instrument such as embouchure dystonia. Shisha also known as hookah or waterpipe is a tobacco pipe with a long flexible tube that draws the smoke through water contained in a bowl. It is extremely common recreation activity in the middle-east with world-wide prevalence of daily use of more than 100 million people.  We report the first case of an Arabic man who developed oromandibular dystonia due to smoking shisha/hookah.

Method: Case report

Results: 52-year-old man who developed involuntary movements involving mouth, 3 years ago. Symptoms initially started only when he smokes shisha. After 2 years, it progressed to even when he is talking. He has history of shisha smoking for the past 30 years. On examination he has lingual and oromandibular dystonia when he smokes shisha and during speaking.  Symptoms improve to some extent when he eats chewing gum. No other accompanying symptoms and normal neurological examination. No family history of movement disorders. Brain imaging was normal. Patient refused botulinum toxin injections.

Conclusion: We report the first case of focal task specific dystonia which is related to smoking shisha/hookah. To our knowledge, chronic use of shisha has never been reported to cause task specific focal dystonia.

To cite this abstract in AMA style:

S. Mittal, H. Yu, P. Krystkowiak. Task Specific Oromandibular dystonia due to Shisha (Hookah) Smoking- “Shisha Dystonia” [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/task-specific-oromandibular-dystonia-due-to-shisha-hookah-smoking-shisha-dystonia/. Accessed July 10, 2025.
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