Down syndrome: orofacial pain, masticatory muscle hypotonia, and sleep disorders

Abstract

The aim of the present study was to investigate orofacial pain in individuals with Down syndrome (DS) and determine possible associations with masticatory muscle hypotonia (MMH), maximum mouth opening (MMO), and sleep disorders. Twenty-three individuals with DS underwent a standardized clinical examination using Axis I of the Diagnostic Criteria for Temporomandibular Disorders, for the diagnosis of pain in the masseter and temporal muscles and temporomandibular joint (TMJ). MMH was investigated using electromyography of the temporal and masseter muscles and the measurement of maximum bite force (MBF). MMO was measured using analog caliper. Sleep disorders (obstructive sleep apnea [OSA], snoring index [SI] and sleep bruxism index [SBI]) were investigated using type II polysomnography. Statistical analysis was performed. Non-significant differences were found in muscle and TMJ pain between the sexes. However, myalgia and referred myofascial pain in the left masseter muscle were more frequent in males (69%) than females (40%). Electrical activity of the temporal (left: p = 0.002; right: p= 0.004) and masseter (left: p= 0.008) muscles was significantly lower in males than in females. MBF range was lower in males than females, indicating highest MMH among males. OSA, SI, and SBI were identified in both sexes, but with no statistically significant differences. We concluded that myalgia and referred myofascial pain were found in some individuals with DS, especially in males. Arthralgia was found mainly in females. Temporal and masseter myalgia may have exerted an influence on the severity of MMH in males, particularly on the left side.

Bruxism in a Child with Trisomy 21 (Down Syndrome)—Case Report

“…It has been found that men with Down syndrome more often suffer from myofascial pain, muscle hypotonia, obstructive sleep apnea, and snoring. Women with DS, on the other hand, report joint pain and SB more often [29]. The hypermobility characteristic of Down syndrome also confirms the problem with disorders of the temporomandibular joints and their excessive mobility, which is manifested by cracking in the joint and malocclusion [7].…”

Concurrent combined methylmalonic acidemia and homocystinuria with down syndrome in a Chinese preschool Child: An in-depth case report and literature review

“…Obstructive sleep apnea (OSA) is a prevalent sleep issue among DS patients, with an almost 100 % prevalence rate in adolescent and adult patient populations [ 15 ]. Furthermore, pediatric DS populations often experience bedtime resistance, sleep anxiety, night awakenings, disrupted sleep patterns, and excessive daytime somnolence [ 16 ].…”

Morphostructural changes in the brain of experimental animals after using mesenchymal stem cells in the temporomandibular joint inflammation model

“…Тригеминокардиальный рефлекс может возникать при надавливании на глазные яблоки, во время операционных процедур, в том числе в периорбитальной области, при резекции опухолей в области моста и мозжечка, а повреждение проекций афферентной иннервации в области верхней и нижней челюсти повышает вероятность снижения уровня артериального давления, развития брадикардии, асистолии, апноэ во время бодрствования, а также усиливает перистальтическую функцию желудочно-кишечного тракта [4,5]. Поскольку центростремительные нервы в составе тригеминоспинального солитарного тракта от лицевой области способны активировать ноцицептивные соматовисцеральные и висцеро-висцеральные рефлексы, характерная для повышенной возбудимости системы тройничного нерва циркуляция возбуждения по замкнутому кругу проявляется различными дисфункциями: невралгией тройничного нерва, лицевыми болями, мигренеподобными состояниями, бруксизмом [5,6]. Причем сонный бруксизм как более интенсивная форма ритмической активности жевательных мышц в 8 % случаев сопровождается остановкой работы сердца [3].…”