Skip to main content

Advertisement

SpringerLink
Log in

Bruxism in Acute Neurologic Illness

  • Secondary Headache (M Robbins, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

While traditionally encountered in ambulatory settings, bruxism occurs in patients with a variety of acute neurologic illnesses including encephalitis, intracerebral hemorrhage, traumatic brain injury, hypoxic-ischemic encephalopathy, and acute ischemic stroke. Untreated bruxism in acute neurologic illness can lead to tooth loss, difficulty in mouth care resulting in recurrent aspiration pneumonia, endotracheal tube dislodgement, and even tongue laceration or amputation. Inpatient clinicians should be aware of the etiologies and management strategies for bruxism secondary to acute neurologic illness.

Recent Findings

Management strategies for bruxism are varied and include pharmacologic and non-pharmacologic therapies in addition to onabotulinumtoxinA (BoNT-A).

Summary

Bruxism impacts patients with a variety of acute neurologic illnesses, and emerging evidence suggests successful and safe treatment strategies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rugh JD, Harlan J. Nocturnal bruxism and temporomandibular disorders. Adv Neurol. 1988;49:329–41.

    CAS  PubMed  Google Scholar 

  2. • Ella B, Ghorayeb I, Burbaud P, Guehl D. Bruxism in movement disorders: a comprehensive review. J Prosthodont 2017:599–605. Recent review of bruxism in movement disorders.

  3. Dhanrajani PJ, Jonaidel O. Trismus: aetiology, differential diagnosis and treatment. Dent Update. 2002;29:88–92 94.

    Article  CAS  Google Scholar 

  4. Kato T, Masuda Y, Yoshida A, Morimoto T. Masseter EMG activity during sleep and sleep bruxism. Arch Ital Biol. 2011;149:478–91.

    CAS  PubMed  Google Scholar 

  5. Yi HS, Kim HS, Seo MR. Trial of oral metoclopramide on diurnal bruxism of brain injury. Ann Rehabil Med. 2013;37:871–4.

    Article  Google Scholar 

  6. Kwak YT, Han IW, Lee PH, Yoon JK, Suk SH. Associated conditions and clinical significance of awake bruxism. Geriatr Gerontol Int. 2009;9:382–90.

    Article  Google Scholar 

  7. Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K. Bruxism physiology and pathology: an overview for clinicians. J Oral Rehabil. 2008;35:476–94.

    Article  CAS  Google Scholar 

  8. Clark GT, Ram S. Four oral motor disorders: bruxism, dystonia, dyskinesia and drug-induced dystonic extrapyramidal reactions. Dent Clin N Am. 2007;51:225–43 viii–ix.

  9. İnan R, Şenel GB, Yavlal F, Karadeniz D, Gündüz A, Kızıltan ME. Sleep bruxism is related to decreased inhibitory control of trigeminal motoneurons, but not with reticulobulbar system. Neurol Sci. Springer-Verlag Italia s.r.l. 2017;38:75–81.

    Article  Google Scholar 

  10. Feu D, Catharino F, Quintão CCA, Almeida MA d O. A systematic review of etiological and risk factors associated with bruxism. J Orthod. 2013;40:163–71.

    Article  Google Scholar 

  11. Pratap-Chand R, Gourie-Devi M. Bruxism: its significance in coma. Clin Neurol Neurosurg. 1985;87:113–7.

    Article  CAS  Google Scholar 

  12. Garrett AR, Hawley JS. SSRI-associated bruxism: a systematic review of published case reports. Neurol Clin Pract. 2018;8:135–41.

    Article  Google Scholar 

  13. Ohrbach R, Michelotti A. The role of stress in the etiology of oral parafunction and myofascial pain. Oral Maxillofac Surg Clin North Am. 2018;30:369–79.

    Article  Google Scholar 

  14. Mohamed SE, Christensen LV, Penchas J. A randomized double-blind clinical trial of the effect of amitriptyline on nocturnal masseteric motor activity (sleep bruxism). Cranio. Maney Publishing. 1997;15:326–32.

    Article  CAS  Google Scholar 

  15. Guaita M, Högl B. Current treatments of bruxism. Curr Treat Options Neurol. 2016;18(2):10.

  16. Kobal F, Baqer A, Shanthini Singaram J. Botulinum toxin A for spastic trismus due to brain stem encephalitis in a pediatric intensive care setting: a unique case report. J Pediatr Intensive Care. Georg Thieme Verlag KG. 2018;07:216–8.

    Article  Google Scholar 

  17. Cohen SG, Quinn PD. Facial trismus and myofascial pain associated with infections and malignant disease. Oral Surg Oral Med Oral Pathol. 1988;65:538–44.

    Article  CAS  Google Scholar 

  18. Urriola N, Soosapilla K, Drummond J, Thieben M. Fulminant thymomatous AMPAR-antibody limbic encephalitis with hypertonic coma, bruxism, anisoelectric electroencephalogram and temporal cortical atrophy, with recovery.BMJ Case Rep. 2019;12(2).

  19. Dalmau J, Gleichman AJ, Hughes EG, Rossi JE, Peng X, Lai M, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol. 2008;7:1091–8.

    Article  CAS  Google Scholar 

  20. Pollack IA, Cwik V. Bruxism following cerebellar hemorrhage. Neurology. 1989;39:1262.

    Article  CAS  Google Scholar 

  21. Kesikburun S, Alaca R, Aras B, Tuǧcu I, Tan AK. Botulinum toxin injection for bruxism associated with brain injury: case report. J Rehabil Res Dev. Rehabilitation Research and Development Service. 2014;51:661–4.

    Article  Google Scholar 

  22. El Maaytah M, Jerjes W, Upile T, Swinson B, Hopper C, Ayliffe P. Bruxism secondary to brain injury treated with botulinum toxin-A: a case report. Head Face Med. 2006;2:41.

    Article  Google Scholar 

  23. Janati AB, Alghasab NS, Alghassab FS. Bruxism associated with anoxic encephalopathy: successful treatment with baclofen. Case Rep Dent. Hindawi Limited. 2013;2013:1–3.

    Google Scholar 

  24. Kim S-G, Kim M-J, Cha M-J, Cho S-J, Kwon K-H, Minn Y-K. Delayed-onset continuous bruxism with olivary hypertrophy after top of the basilar syndrome. J Clin Neurol. Korean Neurological Association. 2006;2:206.

    Article  Google Scholar 

  25. Tan EK, Chan LL, Chang HM. Severe bruxism following basal ganglia infarcts: Insights into pathophysiology. J Neurol Sci. Elsevier. 2004;217:229–32.

    Article  Google Scholar 

  26. • Jankovic J. An update on new and unique uses of botulinum toxin in movement disorders. Toxicon. 2018;147:84–8 Recent review of botulinum toxin in movement disorders.

  27. Huynh N, Lavigne GJ, Lanfranchi PA, Montplaisir JY, De Champlain J. The effect of 2 sympatholytic medications - propranolol and clonidine - on sleep bruxism: experimental randomized controlled studies. Sleep. American Academy of Sleep Medicine. 2006;29:307–16.

    Article  Google Scholar 

  28. Valiente López M, van Selms MKA, van der Zaag J, Hamburger HL, Lobbezoo F. Do sleep hygiene measures and progressive muscle relaxation influence sleep bruxism? Report of a randomised controlled trial. J Oral Rehabil. 2015;42:259–65.

    Article  Google Scholar 

  29. Klasser GD, Greene CS. Oral appliances in the management of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:212–23.

    Article  Google Scholar 

  30. van der Zaag J, Lobbezoo F, Wicks DJ, Visscher CM, Hamburger HL, Naeije M. Controlled assessment of the efficacy of occlusal stabilization splints on sleep bruxism. J Orofac Pain. 2005;19:151–8.

    PubMed  Google Scholar 

  31. Harada T, Ichiki R, Tsukiyama Y, Koyano K. The effect of oral splint devices on sleep bruxism: a 6-week observation with an ambulatory electromyographic recording device. J Oral Rehabil. 2006;33:482–8.

    Article  CAS  Google Scholar 

  32. Gagnon Y, Mayer P, Morisson F, Rompré PH, Lavigne GJ. Aggravation of respiratory disturbances by the use of an occlusal splint in apneic patients: a pilot study. Int J Prosthodont. 17:447–53.

  33. Nikolopoulou M, Ahlberg J, Visscher CM, Hamburger HL, Naeije M, Lobbezoo F. Effects of occlusal stabilization splints on obstructive sleep apnea: a randomized controlled trial. J Orofac Pain. 2013;27:199–205.

    Article  Google Scholar 

  34. Lobbezoo F, Lavigne GJ, Tanguay R, Montplaisir JY. The effect of the catecholamine precursor L-dopa on sleep bruxism: a controlled clinical trial. Mov Disord. 1997;12:73–8.

    Article  CAS  Google Scholar 

  35. Lavigne GJ, Soucy JP, Lobbezoo F, Manzini C, Blanchet PJ, Montplaisir JY. Double-blind, crossover, placebo-controlled trial of bromocriptine in patients with sleep bruxism. Clin Neuropharmacol. 2001;24:145–9.

    Article  CAS  Google Scholar 

  36. Pidcock FS, Wise JM, Christensen JR. Treatment of severe post-traumatic bruxism with botulinum toxin-A: case report. J Oral Maxillofac Surg. 2002;60:115–7.

    Article  Google Scholar 

  37. Matak I, Lacković Z. Botulinum toxin A, brain and pain. Prog Neurobiol. 119–120:39–59.

  38. Fernández-Núñez T, Amghar-Maach S, Gay-Escoda C. Efficacy of botulinum toxin in the treatment of bruxism: systematic review. Med Oral Patol Oral Cir Bucal. Medicina Oral S.L. 2019;24:e416–24.

    PubMed  PubMed Central  Google Scholar 

  39. •• Ondo WG, Simmons JH, Shahid MH, Hashem V, Hunter C, Jankovic J. Onabotulinum toxin-A injections for sleep bruxism. Neurology. Lippincott Williams and Wilkins; 2018;90:e559–64. Randomized controlled trial of onabotulinum toxin-A in treatment of sleep bruxism.

  40. Ivanhoe CB, Lai JM, Francisco GE. Bruxism after brain injury: successful treatment with botulinum toxin-A. Arch Phys Med Rehabil. 1997;78:1272–3.

    Article  CAS  Google Scholar 

  41. Guaita M, van Eendenburg C, Donaire A, Aparicio J, Setoain X, Bargalló N, et al. Ictal bruxism treated with temporal lobectomy. Sleep Med. Elsevier. 2015;16:1429–31.

    Article  Google Scholar 

  42. Richter D, Saft C, Tönges L. Emergence of bruxism after reducing left pallidal stimulation in a patient with Huntington’s disease. Mov Disord Clin Pract. 2020;7:704–5.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Neurocritical Care, Weill Cornell Medicine, New York Presbyterian, 525 East 68th St, RM F610, New York, NY, 10065, USA

    Devin J. Burke & Judy H. Ch’ang

  2. Department of Neurology, Weill Cornell, New York Presbyterian, New York, NY, USA

    Alison Seitz & Matthew S. Robbins

  3. Weill Cornell Medical College, New York, NY, USA

    Oluwatobi Aladesuru

Authors
  1. Devin J. Burke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alison Seitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Oluwatobi Aladesuru
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Matthew S. Robbins
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Judy H. Ch’ang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Judy H. Ch’ang.

Ethics declarations

Conflict of Interest

Dr. Burke MD has nothing to disclose. Dr. Seitz has nothing to disclose. Mr. Aladesuru has nothing to disclose. Dr. Robbins reports serving on the Board of Directors of the American Headache Society and the New York State Neurological Society in non-remunerative positions. He receives book royalties from Wiley and serves editorial positions for Headache and Current Pain and Headache Reports. Dr. Ch’ang has nothing to disclose.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Secondary Headache

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Burke, D.J., Seitz, A., Aladesuru, O. et al. Bruxism in Acute Neurologic Illness. Curr Pain Headache Rep 25, 41 (2021). https://doi.org/10.1007/s11916-021-00953-4

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11916-021-00953-4

Keywords

Search

Navigation