Trial of oral metoclopramide on diurnal bruxism of brain injury.
Bruxism is a diurnal or nocturnal parafunctional activity that includes tooth clenching, bracing, gnashing, and grinding. The dopaminergic system seems to be the key pathophysiology of bruxism and diminution of dopaminergic transmission at the prefrontal cortex seems to induce it. We report two patients with diurnal bruxism in whom a bilateral frontal lobe injury resulted from hemorrhagic stroke or traumatic brain injury. These patients' bruxism was refractory to bromocriptine but responded to low-dose metoclopramide therapy. We propose that administering low doses of metoclopramide is possibly a sound method for treating bruxism in a brain injury patient with frontal lobe hypoperfusion on positron emission tomography imaging.
Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Ho Sung
HS
Yi
Department of Physical Medicine and Rehabilitation, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
Hyoung Seop
HS
Kim
Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Mi Ri
MR
Seo
Bruxism; Dopamine receptors; Metoclopramide