Effectiveness of botulinum toxin type A treatment of neck pain related to nocturnal bruxism: a case report

Abstract

Objective: This case report describes a patient with nocturnal bruxism and related neck pain treated with botulinum toxin type A (BTX-A). Clinical Features: The patient was a 27-year-old man with nocturnal bruxism and difficulty in active mouth opening and chewing and neck pain at rest. His numeric pain score was 7 of 10. Surface electromyography of the temporalis and masseter muscles showed typical signs of hyperactivity, characterized by compound muscle action potential amplitude alterations. Intervention and Outcome: After clinical evaluation, he was treated with BTX-A to reduce masseter and temporalis muscle hyperactivity. After 3 days of treatment with BTX-A, with each masseter muscle injected with a dose of about 40 mouse units with a dilution of 1 mL and with temporal muscle bilaterally injected with 25 mouse units with the same dilution, a decrease in bruxism symptoms was reported. Neck pain also decreased after the first treatment (visual analog scale of 2/10) and then resolved completely. After 4 weeks, electromyography showed the reduction of muscle hyperactivity with a decrease in the amplitude of the motor action potential. The same reduction in signs and symptoms was still present at assessment 3 months posttreatment. Conclusion: These findings suggest that BTX-A may be a therapeutic option for the treatment of bruxism and related disorders.

The Evaluation of the Clinical Effects of Botulinum Toxin on Nocturnal Bruxism

“…Similarly, Santamato et al [25] reported that neck pain related to nocturnal bruxism can be treated with BTXA. In the study by Santamato et al [25], the dose of BTXA injected into each masseter muscle was 40 MU and 25 MU was injected into each temporalis muscle.…”

Botulinum toxin type A combined with cervical spine manual therapy for masseteric hypertrophy in a patient with Alzheimer-type dementia: a case report

“…24 Bruxism involves jaw clenching and grinding of the teeth, commonly causes myofascial pain, and is often resistant to treatment. 2 A higher prevalence rate of bruxism has been reported in cranial-cervical dystonia compared with healthy control. 25 Patients with neurological disorders who are in a comatose state can also have severe bruxism.…”

“…1 Resolution of bruxism may be associated with improvement in the level of consciousness. 2 It seems that there is an intimate functional relationship between the temporomandibular joint and the cervical spine, as suggested by their anatomical and biomechanical interrelationships, although current evidence is conflicting. 3 Eriksson et al 4 reported that mouth opening is accompanied by head-neck extension and mouth closing is accompanied by head-neck flexion, with a precise coordination between jaw-neck movements dependent on the speed of the movement.…”

Orthodontic management by functional activator treatment: a case report

“…Last, but not least, mouth breathers with a low tongue posture often have chronic neck pain and poor posture. The literature shows that the tongue and neck muscles are related because of common proprioception by a common trunk from the ansa cervicalis through the hypoglossal nerve [17–19]. …”