Bruxism after brain injury: successful treatment with botulinum toxin-A

Arch Phys Med Rehabil. 1997 Nov;78(11):1272-3. doi: 10.1016/s0003-9993(97)90343-9.

Abstract

Bruxism, the rhythmic grinding of teeth--usually during sleep--is not an infrequent complication of traumatic brain injury. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown. Untreated, bruxism causes masseter hypertrophy, headache, temporomandibular joint destruction, and total dental wear. We report a case of complete resolution of postanoxic bruxism after treatment with botulinum toxin-A (BTX-A). The patient was a 28-year-old man with no history of bruxism who sustained an anoxic brain injury secondary to cardiac arrest of unknown etiology. On admission to our rehabilitation unit 2 months after the injury, the patient presented with severe bruxism and heavy dental wear. The patient was injected with a total of 200 units of BTX-A to each masseter and temporalis. There was total resolution of bruxism 2 days after injection, with no complications. On follow-up 3 months after injection, the patient remained free of bruxism. We propose that botulinum toxin be considered as a treatment for bruxism secondary to anoxic brain injury. Further studies regarding muscle selection and medication dosage are warranted to elucidate the toxin's efficacy in this condition.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Botulinum Toxins, Type A / therapeutic use*
  • Brain Injuries / complications*
  • Bruxism / etiology
  • Bruxism / therapy*
  • Humans
  • Male
  • Neuromuscular Agents / therapeutic use*

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A