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

Behavioral and Brain Functions

Gianni Frisardi³  Cesare Iani⁵  Gianfranco Sau⁷  Flavio Frisardi⁶  Carlo Leornadis²  Aurea Lumbau⁸  Paolo Enrico¹  Donatella Sirca¹  Enrico Maria Staderini⁴  Giacomo Chessa³ 

[1] Neuropharmacology Department, University of Sassari, Sassari, Italy

[2] Department of Anesthesiology, Tor Vergata University, Rome, Italy

[3] Department of Oral Rehabilitation, University of Sassari, Sassari, Italy

[4] Western Switzerland University of Applied Sciences, HEIG-VD, Yverdon-les-Bains, Switzerland

[5] Department of Neurology, Santo Eugenio Hospital, Rome, Italy

[6] Epochè “Orofacial Pain Center”, Rome, Italy

[7] Institute of Clinical Neurology, University of Sassari, Sassari, Italy

[8] Department of Medical-Surgical Speciality, University of Sassari, Sassari, Italy

关键词: Bilateral Root-MEPs;    Trigeminal electrophysiology;    Oro facial dystonia;    Dystonia;    Temporomandibular disorders;    Orofacial pain;    Bruxism;   

Others  :  793145
DOI  :  10.1186/1744-9081-9-41

 received in 2013-04-19, accepted in 2013-10-17,  发布年份 2013

【 摘 要 】

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.

【 授权许可】

   
2013 Frisardi et al.; licensee BioMed Central Ltd.

【 图 表 】

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