title: Unilateral or "side-locked" migrainous headache with autonomic symptoms linked to night guard use.
abstract: Night guards are commonly prescribed as a palliative measure for bruxism, temporomandibular joint symptoms, and associated disorders. We describe a patient with a 10- to 12-year history of night guard use with concurrent unilateral side-locked migrainous headaches with autonomic symptoms characteristic of trigeminal autonomic cephalgia. These headaches were refractory to numerous pharmacological interventions. Upon self-initiated cessation of night guard use, there was complete remission of headaches. We believe the headaches were initiated by night guard-initiated irritation of the trigeminal nerve and a trigeminal autonomic reflex resulting in unilateral migrainous headache with autonomic signs.
authors.affiliation: Texas Tech University Health Sciences Center - Cell Physiology and Molecular Biophysics, Lubbock, TX 79430, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Strahlendorf
authors.forename: Randolph
authors.initials: R
authors.lastname: Schiffer
authors.forename: Howard
authors.initials: H
authors.lastname: Strahlendorf
mesh_terms: D020211:Autonomic Dysreflexia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D009064:Mouth Protectors / Q000009:adverse effects*; D012021:Reflex, Abnormal / Q000502:physiology; D020186:Sleep Bruxism / Q000503:physiopathology / Q000628:therapy; D051303:Trigeminal Autonomic Cephalalgias / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D014276:Trigeminal Nerve / Q000033:anatomy & histology / Q000503:physiopathology*; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology