title: Chronic daily headache: suggestion for the neuromuscular oral therapy.
abstract: Tweny patients (M: 4, F: 16, mean age 37 ± 11 years) with diagnosis of chronic daily headache (CDH), after drug withdrawal, were under electromyography, kinesiography and masticatory muscle deprogramming by TENS to identify the physiological rest position of the mandible. Our purpose was to clarify a possible role of the neuromuscular stomatognathic system. Examinations showed that 17 patients needed a neuromuscular orthosis, an occlusal device, to provisionally correct the detected discrepancies of jaw position. Of those, the 10 patients who showed an occlusal sagittal discrepancy higher than 2 mm and/or a lateral deviation higher than 0.4 mm, associated with more than three parafunctional activities, had a meaningful decrease on frequency/intensity of migraine crisis and/or of days of headache. VAS pain score during crisis decreased from 9.0 ± 0.9 to 4.9 ± 2.7; frequency of crisis were from 20.7 ± 5.2 to 9.5 ± 7.7. Baseline pain were from 5.3 ± 1.2 to 3.0 ± 1.3. Satisfying clinical results can be reached combining behavioural education and neuromuscular orthosis. This can be very helpful in patients who show significant discrepancy of jaw position that only TENS deprogramming can reveal and kinesiography can detect with such accuracy.
authors.affiliation: Fondazione IRCCS Cà Granda, Dipartimento di Scienze Chirurgiche Ricostruttive e Diagnostiche Sezione di Odontostomatologia, Università degli Studi di Milano, Via della Commenda 10, 10122 Milan, Italy.
authors.forename: H
authors.initials: H
authors.lastname: Didier
authors.forename: C
authors.initials: C
authors.lastname: Marchetti
authors.forename: G
authors.initials: G
authors.lastname: Borromeo
authors.forename: V
authors.initials: V
authors.lastname: Tullo
authors.forename: D
authors.initials: D
authors.lastname: D'amico
authors.forename: G
authors.initials: G
authors.lastname: Bussone
authors.forename: F
authors.initials: F
authors.lastname: Santoro
mesh_terms: D000328:Adult; D004576:Electromyography; D005260:Female; D020773:Headache Disorders / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D017289:Orthodontic Appliances, Functional; D013705:Temporomandibular Joint Disorders / Q000150:complications* / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation