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Indian Journal of Neurotrauma 2014; 11(01): 17-26
DOI: 10.1016/j.ijnt.2014.02.002
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Bruxism in patients of moderate to severe traumatic brain injury: Management results suggesting an etiological mechanism

Pratyush Nirmal Kusum Chaudhuri

Verantwortlicher Herausgeber dieser Rubrik:
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Publikationsverlauf

19. Oktober 2013

02. Februar 2014

Publikationsdatum:
06. April 2017 (online)

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Abstract

Introduction

Bruxism is an unusual event among patients of altered sensorium after brain injury. Occasionally the bruxism may be so severe as to cause harm to the patients and make nursing difficult. This study presents such cases that were managed by the author. A possible explanation for post-brain injury bruxism is suggested.

Material and method

Twelve patients of brain injury following trauma who were observed to have bruxism were included in the study. The clinical presentation and the response to intervention were studied. Patients less then 16 years were managed with benzodiazepines only. Patients more than 16 years of age were managed with benzodiazepines and pramipexole was administered in addition to benzodiazepines in 5 patients.

Observation

Of the 12 patients 3 subjects were classified as severe brain injury. Nine patients had suffered moderate grade brain injury. 3 (25%) patients were children and the mean age of the rest 9 (75%) patients was 40 years. The children were managed with benzodiazepines. The median time of onset of bruxism from the time of injury was 5.25 days with range of 2 days–12 days. Pramipexole, a dopamine agonist, was useful in management of severe bruxism with a latency period of 2 days. All patients except one recovered within 7 days after starting the treatment.

Conclusion

Bruxism is distressing to a patient-in-recovery following brain injury and cause significant inconvenience to the nursing staff. Effective treatment included the use of benzodiazepines and pramipexole. Pramipexole, a dopamine receptor agonist, should be considered an option for pharmacological management of bruxism after brain trauma. If central pattern generators (CPG) are involved in some of the disabilities of moderate to severe brain injuries like bruxism, there is a rationale for considering a larger study for the use of dopamine receptor agonist in such patients.

Keywords

Brain injury - Bruxism - Pramipexole - Central pattern generators - Dopamine agonist