A relationship between bruxism and orofacial-dystonia? A trigeminal electrophysiological approach in a case report of pineal cavernoma

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• 作者：Gianni Frisardi (15) (9)
  Cesare Iani (10)
  Gianfranco Sau (11)
  Flavio Frisardi (15)
  Carlo Leornadis (12)
  Aurea Lumbau (13)
  Paolo Enrico (14)
  Donatella Sirca (14)
  Enrico Maria Staderini (15)
  Giacomo Chessa (9)
  
• 关键词：Bruxism ; Orofacial pain ; Temporomandibular disorders ; Dystonia ; Oro facial dystonia ; Trigeminal electrophysiology ; Bilateral Root ; MEPs
• 刊名：Behavioral and Brain Functions
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：9
• 期：1
• 全文大小：347 KB
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• 作者单位：Gianni Frisardi (15) (9)
  Cesare Iani (10)
  Gianfranco Sau (11)
  Flavio Frisardi (15)
  Carlo Leornadis (12)
  Aurea Lumbau (13)
  Paolo Enrico (14)
  Donatella Sirca (14)
  Enrico Maria Staderini (15)
  Giacomo Chessa (9)
  
  15. Western Switzerland University of Applied Sciences, HEIG-VD, Yverdon-les-Bains, Switzerland
  9. Department of Oral Rehabilitation, University of Sassari, Sassari, Italy
  10. Department of Neurology, Santo Eugenio Hospital, Rome, Italy
  11. Institute of Clinical Neurology, University of Sassari, Sassari, Italy
  12. Department of Anesthesiology, Tor Vergata University, Rome, Italy
  13. Department of Medical-Surgical Speciality, University of Sassari, Sassari, Italy
  14. Neuropharmacology Department, University of Sassari, Sassari, Italy
  
• ISSN：1744-9081

文摘

Background In some clinical cases, bruxism may be correlated to central nervous system hyperexcitability, suggesting that bruxism may represent a subclinical form of dystonia. To examine this hypothesis, we performed an electrophysiological evaluation of the excitability of the trigeminal nervous system in a patient affected by pineal cavernoma with pain symptoms in the orofacial region and pronounced bruxism. Methods Electrophysiological studies included bilateral electrical transcranial stimulation of the trigeminal roots, analysis of the jaw jerk reflex, recovery cycle of masseter inhibitory reflex, and a magnetic resonance imaging study of the brain. Results The neuromuscular responses of the left- and right-side bilateral trigeminal motor potentials showed a high degree of symmetry in latency (1.92?ms and 1.96?ms, respectively) and amplitude (11?mV and 11.4?mV, respectively), whereas the jaw jerk reflex amplitude of the right and left masseters was 5.1?mV and 8.9?mV, respectively. The test stimulus for the recovery cycle of masseter inhibitory reflex evoked both silent periods at an interstimulus interval of 150?ms. The duration of the second silent period evoked by the test stimulus was 61?ms and 54?ms on the right and left masseters, respectively, which was greater than that evoked by the conditioning stimulus (39?ms and 35?ms, respectively). Conclusions We found evidence of activation and peripheral sensitization of the nociceptive fibers, the primary and secondary nociceptive neurons in the central nervous system, and the endogenous pain control systems (including both the inhibitory and facilitatory processes), in the tested subject. These data suggest that bruxism and central orofacial pain can coexist, but are two independent symptoms, which may explain why numerous experimental and clinical studies fail to reach unequivocal conclusions.