Abstract
Bruxism characterized by clenching and grinding of teeth can lead to toothwear, headaches
and depression. While bruxism has been associated with a number of neurological diseases,
it has not been highlighted following cerebral infarction.
An elderly man presented with an acute onset of tooth grinding and jaw clenching associated
with dysarthria. His bruxism was worse during the day and resolved during sleep. He
had frequent jaw aches, headaches and swallowing difficulty. Examination demonstrated
the presence of dysarthria with jaw clenching and tooth grinding, producing persistent
high pitch and loud squeaky sounds. A magnetic resonance imaging and angiography examination
revealed a recent infarct in the right thalamus. In addition, chronic lacunar infarcts
were present in the bilateral caudate nuclei with severe basilar artery stenosis.
He was successfully treated with botulinum toxin.
We discuss the pathophysiologic mechanisms of bruxism associated with basal ganglia
infarcts. Dysfunction of the efferent and/or afferent thalamic or striatopallidal
tracts may play a role in bruxism. Early recognition of bruxism following stroke could
reduce unnecessary suffering since the condition can be effectively treated.
Keywords
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Article info
Publication history
Accepted:
October 15,
2003
Received in revised form:
September 19,
2003
Received:
June 30,
2003
Identification
Copyright
© 2003 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
