title: Bruxism after brain injury: successful treatment with botulinum toxin-A.
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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
authors.forename: C B
authors.initials: CB
authors.lastname: Ivanhoe
authors.forename: J M
authors.initials: JM
authors.lastname: Lai
authors.forename: G E
authors.initials: GE
authors.lastname: Francisco
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D001930:Brain Injuries / Q000150:complications*; D002012:Bruxism / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A