Effectiveness of botulinum toxin type A treatment of neck pain related to nocturnal bruxism: a case report.
OBJECTIVE
This case report describes a patient with nocturnal bruxism and related neck pain treated with botulinum toxin type A (BTX-A).


METHODS
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.


RESULTS
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.


CONCLUSIONS
These findings suggest that BTX-A may be a therapeutic option for the treatment of bruxism and related disorders.
Assistant Professor, Department of Physical Medicine and Rehabilitation-"OORR," University of Foggia, Foggia, Italy.
Andrea
A
Santamato
Francesco
F
Panza
Daniela
D
Di Venere
Vincenzo
V
Solfrizzi
Vincenza
V
Frisardi
Maurizio
M
Ranieri
Pietro
P
Fiore