Hypertonia and hyperactivity of masticatory muscles are involved in
pain and contractions of the cervical spine musculature, but their pathophysiology remains nonetheless unknown and its treatment far to be codified. In this study, 8 patients, showing disabling posterior neck muscle
contractures linked with
bruxism were prospectively treated and followed for an average 15 months period, after having received
Injections of
botulinum toxin A essentially in masticatory muscles.
Injections were made every 3 months, varying from 10 to 100 U
Botox* by muscles, without administrating more than 300 U
Botox* in the same patient. The angle of cervical
lordosis were calculated on lateral sitting radiographs in neutral position, good results being considered to be achieved in the case of a 2 point diminution of VAS score as well as at least a 5° positive gain in the curve. 7 patients out of 8 showed a real improvement in their symptoms after an average of 3
injections, showing a decrease of 4.5 points on the VAS score and an average increment of 15° in cervical
lordosis. Although the follow-up period of patients was relatively short and the sample quite small, the general impression, confirmed by the patients' experience, seems to suggest a potential place for the use of
botulinum toxin amongst the array of treatments which can be offered in certain selected cases which associate
bruxism and posterior cervical contractions.