Melatonin secretion and the pathophysiology of Meige's disease (idiopathic orofacial dystonia): a hypothesis.

Meige's disease is a form of focal dystonia characterized by symmetric dystonic spasms of facial muscles, sometimes associated with dystonic movements of other midline muscle groups. The etiology and pathophysiology of the disease have not been established. There is evidence that Meige's disease may result from striatal dopaminergic preponderance coupled with cholinergic overactivity. Several authors have noted a high prevalence of depression in patients with Meige's disease, suggesting a common neurochemical abnormality. Depression, in turn, is associated with decreased pineal melatonin secretion. We propose, based on studies demonstrating that melatonin regulates dopaminergic, cholinergic and GABA-ergic functions, that alterations in melatonin functions may enhance the development of the disease. This hypothesis may open new avenues toward understanding the pathophysiology of the disease and developing newer therapeutic strategies.