BACKGROUND: Temporomandibular disorder (TMD) and chronic tension headaches clinically coexist in many individuals. Generally considered as separate pathological entities, they have been clinically treated by different means. OBJECTIVE: To determine the utility of treatment with botulinum toxin for patients with coexisting TMD and chronic tension type headache. METHODS: In this open-label study of 60 subjects with chronic TMD, 46 subjects also met the diagnostic criteria for chronic tension headache. All 60 subjects were treated with 150 units of botulinum toxin-A injected into the masticatory muscles, specifically 50 units into each masseter and 25 units into each temporalis muscle. RESULTS: Thirty-eight of 60 subjects (63%) reported a 50% improvement in their facial pain during the follow-up period. The subset of 46 subjects with chronic tension headache and TMD symptoms reported a 50% or greater improvement in headache pain as well. The number of headache free days also improved postinjection. CONCLUSION: These results suggest that the masticatory muscles, specifically the temporalis, may be involved in the pathogenesis of this form of chronic tension headache found in association with TMD.
BACKGROUND:Temporomandibular disorder (TMD) and chronic tension headaches clinically coexist in many individuals. Generally considered as separate pathological entities, they have been clinically treated by different means. OBJECTIVE: To determine the utility of treatment with botulinum toxin for patients with coexisting TMD and chronic tension type headache. METHODS: In this open-label study of 60 subjects with chronic TMD, 46 subjects also met the diagnostic criteria for chronic tension headache. All 60 subjects were treated with 150 units of botulinum toxin-A injected into the masticatory muscles, specifically 50 units into each masseter and 25 units into each temporalis muscle. RESULTS: Thirty-eight of 60 subjects (63%) reported a 50% improvement in their facial pain during the follow-up period. The subset of 46 subjects with chronic tension headache and TMD symptoms reported a 50% or greater improvement in headache pain as well. The number of headache free days also improved postinjection. CONCLUSION: These results suggest that the masticatory muscles, specifically the temporalis, may be involved in the pathogenesis of this form of chronic tension headache found in association with TMD.
Authors: Carlo Di Paolo; G Damiana Costanzo; Fabrizio Panti; Alessandro Rampello; Giovanni Falisi; Andrea Pilloni; Piero Cascone; Giorgio Iannetti Journal: Ann Stomatol (Roma) Date: 2013-03-20
Authors: Reggie C Hamdy; Kathleen Montpetit; Joanne Ruck-Gibis; Kelly Thorstad; Ellen Raney; Michael Aiona; Robert Platt; Allen Finley; William Mackenzie; James McCarthy; Unni Narayanan Journal: Trials Date: 2007-09-28 Impact factor: 2.279