Ann Rehabil Med.  2013 Dec;37(6):871-874. 10.5535/arm.2013.37.6.871.

Trial of Oral Metoclopramide on Diurnal Bruxism of Brain Injury

• Yi HS
• Kim HS
• Seo MR

• KMID: 2266566
• DOI: http://doi.org/10.5535/arm.2013.37.6.871

Abstract

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.

Keyword

Bruxism; Dopamine receptors; Metoclopramide

MeSH Terms

Braces
Brain Injuries*
Brain*
Bromocriptine
Bruxism*
Frontal Lobe
Humans
Metoclopramide*
Positron-Emission Tomography
Prefrontal Cortex
Receptors, Dopamine
Stroke
Tooth
Bromocriptine
Metoclopramide
Receptors, Dopamine

Figure

• 

  Fig. 1 Magnetic resonance imaging of the brain from case 1, showing subacute intracranial hemorrhage in the left basal frontal lobe (arrows). Positron emission tomography also shows metabolic defects in the left basal frontal lobe along with diffuse hypometabolism in the bilateral frontal, temporal, and parietal cortex.

• 

  Fig. 2 A cranial computerized tomography scan from case 2, showing extensive encephalomalacia at the bilateral frontal lobes and the right temporal lobe from previous trauma (arrows).

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