J Korean Dent Soc Anesthesiol.  2010 Jun;10(1):13-19. 10.17245/jkdsa.2010.10.1.13.

Bruxism and Oromandibular Dystonia after Brain Injury Treated with Botulinum Toxin A and Occlusal Appliance: A Case Report

• Kim TW
• Baek K
• Song SI

• KMID: 2345092
• DOI: http://doi.org/10.17245/jkdsa.2010.10.1.13

Abstract

Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.

Keyword

Botulinum toxin A (BTX-A); Brain injury; Bruxism; Occlusal appliance; Oromandibular dystonia (OMD)

MeSH Terms

Anesthesia, General
Botulinum Toxins*
Brain Injuries*
Brain*
Bruxism*
Consciousness
Craniotomy
Dystonia*
Follow-Up Studies
Headache
Humans
Hypertrophy
Incidence
Jaw
Middle Aged
Muscles
Prevalence
Temporomandibular Joint
Tongue
Tooth
Tooth Wear
Trismus
Botulinum Toxins