Bruxism after brain injury: Successful treatment with botulinum toxin-A

Cindy B. Ivanhoe, Jenny Lai, Gerard E. Francisco

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Bruxism, the rhythmic grinding of teeth-usually during sleep-is not an infrequent complication of traumatic brain injury. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown. Untreated, bruxism causes masseter hypertrophy, headache, temporomandibular joint destruction, and total dental wear. We report a case of complete resolution of postanoxic bruxism after treatment with botulinum toxin-A (BTX- A). The patient was a 28-year-old man with no history of bruxism who sustained an anoxic brain injury secondary to cardiac arrest of unknown etiology. On admission to our rehabilitation unit 2 months after the injury, the patient presented with severe bruxism and heavy dental wear. The patient was injected with a total of 200 units of BTX-A to each masseter and temporalis. There was total resolution of bruxism 2 days after injection, with no complications. On follow-up 3 months after injection, the patient remained free of bruxism. We propose that botulinum toxin he considered as a treatment for bruxism secondary to anoxic brain injury. Further studies regarding muscle selection and medication dosage are warranted to elucidate the toxin's efficacy in this condition.

Original languageEnglish (US)
Pages (from-to)1272-1273
Number of pages2
JournalArchives of Physical Medicine and Rehabilitation
Issue number11
StatePublished - Nov 1997

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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