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PubMed1991

[Severe late-onset dystonia while on fluspirilene].

Shooting, tonic cramps of the neck muscles with jolt-like contractions in the mouth and jaw regions and propulsive movements of both arms developed in a 25-year-old woman who, over a period of six months, had been given nine intramuscular injections of the depot neuroleptic fluspirilene, 1.5 mg each, because of apathy and depression. Treatment with biperiden (up to 20 mg daily) and benzodiazepines was unsuccessful, while tiapride (up to 1000 mg daily) brought about slight improvement and 15 mg haloperidol achieved complete remission. However, distinct parkinsonian features developed. Slow gradual reduction of the haloperidol dose again led to extrapyramidal motor symptoms, even when tiapride or bromocriptine was given as well. After six months' administration of clozapine, up to 500 mg daily, and gradual dose reduction all symptoms fully regressed. This case demonstrates that the risk of extrapyramidal motor abnormalities from "neuroleptic anxiolysis" should not be underestimated.

Acute Disease↗
PubMed2000

Effect of unilateral posterior crossbite on the electromyographic activity of human masticatory muscles.

Studies dealing with the electromyographic activity of masticatory muscles in patients with unilateral posterior crossbite are infrequent. The purpose of this study was to assess the electromyographic pattern of masticatory muscles at rest position, during swallowing, and during mastication, in 30 subjects with right posterior crossbite and to compare them to 30 normocclusive subjects. The 2 groups were matched according to age, gender, skeletal Class I, and mesofacial growth pattern. Electromyographic activity of right and left anterior temporalis, posterior temporalis, masseter, and anterior digastric muscles was recorded at rest position, while swallowing water, and while chewing. Disposable bipolar surface electrodes were used in both groups. Data were compared between groups and between right and left sides within each group. The results revealed that the posterior temporalis of the non-crossbite side was more active than that of the same side in subjects with crossbite at rest position and during swallowing. The activity of both anterior digastrics was higher in the crossbite subjects during swallowing. During chewing the right masseter muscle was less active in the crossbite patients than in normocclusive subjects. The results obtained during chewing indicate a bilateral masticatory pattern in both groups.

Adolescent↗
PubMed2000

Masticatory muscle activity in children and adults with different facial types.

The purpose of this study was to examine the relationship between the duration of masticatory muscle activity during daytime and vertical craniofacial morphology in children and adults. Thirty children (12 boys and 18 girls) and 30 adults (20 men and 10 women) with normal anteroposterior skeletal relations, acceptable occlusions, and without any temporomandibular joint disorders, were selected as subjects. Activities of the masseter, temporal, and digastric muscles were recorded for 3 hours during daytime, excluding the periods for meals, sleep, and hard-exercise, using a portable electromyogram recording system. A lateral cephalogram was taken of each subject at the intercuspal position to divide the subjects into 3 different facial types, ie, low, average, and high angle groups. Masseter, temporal, and digastric muscle activities mainly consisted of low-amplitude bursts during daytime. Children exhibited longer duration of temporal muscle activity, whereas the masseter muscle presented longer duration of activity in adults. The activities of masseter and digastric muscles were significantly related with the vertical facial type in both children and adults, although temporal muscle activity presented no significant relationship with the craniofacial morphology. The duration of masticatory muscle activity during daytime showed a significant difference between children and adults, indicating a close association with vertical craniofacial morphology in children and adults.

Adult↗
PubMed2001

An evidence-based assessment of occlusal adjustment as a treatment for temporomandibular disorders.

STATEMENT OF PROBLEM: Occlusal adjustment therapy has been advocated as a treatment modality for temporomandibular disorders. In contrast to this position, a panel at the 1996 National Institute of Health technology assessment conference on TMD indicated that no clinical trials demonstrate that occlusal adjustment is superior to noninvasive therapies. PURPOSE: This article summarizes the published experimental studies on occlusal adjustments and temporomandibular disorders. MATERIAL AND METHODS: Eleven research experiments involving 413 subjects with either bruxism (n = 59), temporomandibular disorders (n = 219), headaches and temporomandibular disorders (n = 91), or chronic cervical pain (n = 40) were selected for critical review from the English dental literature. RESULTS: Three experiments evaluated the relationship between occlusal adjustment and bruxism. Six experiments evaluated occlusal adjustment therapy as a treatment for patients with primary temporomandibular disorders. One experiment looked at occlusal adjustment effect on headache/temporomandibular disorder symptoms; another looked at its effect on chronic neck pain. Most of these experiments used a mock adjustment or a comparison treatment as the control condition in adults who had an existing nonacute general temporomandibular disorder. Overall, the data from these experiments did not demonstrate elevated therapeutic efficacy for occlusal adjustment over the control or the contrasting therapy. CONCLUSION: The experimental evidence reviewed was neither convincing nor powerful enough to support the performance of occlusal therapy as a general method for treating a nonacute temporomandibular disorder, bruxism, or headache.

Adult↗
PubMed2001

Evaluation of a pneumatically operated captive bolt for stunning/killing broiler chickens.

1. Two separate experiments were carried out in this study. In experiment 1, the effectiveness of stunning broilers, as determined from physical responses, with a 6 mm diameter bolt and an air line pressure of 827 kPa, when fired at 90 degrees (perpendicular to the skull) 110 degrees, 120 degrees and 130 degrees (leaning towards beak) was evaluated. 2. In experiment 2, the effects of perpendicular shooting with two bolt diameters (3 and 6 mm) and two air line pressures (620 and 827 kPa) on spontaneous behaviour, electroencephalogram (EEG) and visually evoked potentials (VEPs) were evaluated in broilers. 3. Only the perpendicular shooting was effective in stunning/killing broilers (n= 10) as indicated by the immediate cessation of breathing and loss of neck muscle tension and eye reflexes. Deviations from the perpendicular shooting failed to stun 5 out of 9 broilers. The perpendicular vs non-perpendicular effect was significant. 4. Shooting broilers with a 3 mm bolt at air line pressures of 620 kPa (n=2) or 827 kPa (n=2) failed stun as indicated by the unaltered physical reflexes, EEG and VEPs. Shooting of two broilers with a 6 mm bolt at 620 kPa resulted in effective stunning and a very rapid recovery of consciousness in one bird and death in the other. 5. Captive bolt stunning of broilers with a 6 mm bolt and air line pressure of 827 kPa resulted in an immediate stun leading to death in all 6 broilers tested. In these broilers, a profound EEG suppression and abolition of VEPs occurred immediately after shooting. 6. It is suggested that the appropriate variables for captive bolt stunning of broilers are a minimum of 6 mm bolt diameter driven at an air line pressure of 827 kPa and a penetration depth of 10 mm.

Animals↗
PubMed1990

Effect of stunning on spontaneous physical activity and evoked activity in the brain.

1. The effect of stunning current on the time to recovery of physical activity, and on somatosensory evoked potentials (SEPs) in the brain, was examined in broiler chickens. 2. Increasing stunning current was associated with an increase in the time to recovery of tension in the neck muscles and with an increase in the incidence of loss of SEPs. 3. Currents greater than 105 mA per bird provided 52 s or more of apparent insensibility; currents greater than 120 mA were associated with absence of SEPs following the stun.

Abattoirs↗
PubMed1996

Mechanisms controlling head stabilization in the elderly during random rotations in the vertical plane.

Frequency-related response characteristics of the mechanisms controlling stabilization of the head in 10 elderly subjects were compared with response characteristics in 8 young adults. Angular velocity of the head with respect to the trunk and EMG responses of 2 neck muscles were recorded in 10 seated subjects during pseudorandom rotations of the trunk in the sagittal plane at frequencies of 0.35 to 3.05 Hz. Subjects were required to actively stabilize their heads with (VS) and without (NY) visual feedback so that voluntary mechanisms and the influence of vision could be tested. Reflex mechanisms were examined when subjects were distracted by a mental calculation task during rotations in the dark (MA). Age emerged as an influential factor in the performance of head stabilization mechanisms, and decrements in performance were even more pronounced in the older as compared with younger elderly subjects. Age effects could be seen in the (a) diminished ability to voluntarily stabilize the head, particularly with the absence of vision, (b) impaired ability to stabilize the head when cognitively distracted, and (c) appearance of a resonant response of the head. Control of head stabilization shifted from reflex mechanisms to system mechanics, probably as a result of age-related changes in the integrity of the sensory systems. The elderly's system mechanics could not effectively compensate for the disturbances, however, and instability was the result.

Journal Article↗
PubMed1987

Muscle contraction headache. Overview and update of a common affliction.

Muscle contraction headache usually can be correctly diagnosed on the basis of a thorough patient history and physical examination, although diagnostic tests may be necessary to exclude structural or inflammatory disease. Often, symptoms are directly related to emotional conflicts. In most cases, the primary care physician can provide treatment, which includes understanding and emotional support. Pharmacologic therapy and biofeedback are effective in controlling symptoms. Depression should be suspected in patients with chronic headache. Referral for neurologic or psychiatric consultation should be considered if the diagnosis is unclear or therapy is unsatisfactory.

Diagnosis, Differential↗
PubMed1989

Sensitivity, specificity, and the predictive value of facial electromyographic data in diagnosing myofascial pain-dysfunction.

Studies have shown uniformly that myofascial pain-dysfunction/temporomandibular (MPD/TM) patients have higher electromyographic (EMG) activity in the head-neck muscles than do non-MPD/TM subjects. However, no attempt has been made to use facial EMG data in diagnosing MPD/TM conditions. This paper explicates four concepts that can, in principle, serve to guide individual diagnosis using EMG data. It then reports an experiment in which resting facial EMG data were acquired from MPD patients and control subjects, and it evaluates preliminarily the diagnostic utility of the EMG information. The conclusion is offered that diagnosis via EMG is sufficiently promising to justify additional research.

Electromyography↗
PubMed1992

Head posture and cervicovertebral and craniofacial morphology in patients with craniomandibular dysfunction.

A relationship between particular characteristics of dental occlusion and craniomandibular disorders (CMD) has been reported, while less attention has been focused on the possible effect of dysfunction of the masticatory system on head posture or cervicovertebral and craniofacial morphology. Natural head position roentgen-cephalograms of 16 young adults with complete dentition taken before and after stomatognathic treatment displayed an extended head posture, smaller size of the uppermost cervical vertebrae, decreased posterior to anterior face height ratio, and a flattened cranial base as compared with age- and sex-matched healthy controls. The lordosis of the cervical spine straightened after stomatognathic treatment. The results are an indication of the close interrelationship between the masticatory muscle system and the muscles supporting the head, and lead to speculation on the principles of treating craniomandibular disorders.

Adolescent↗
PubMed2002

Interexaminer agreement for muscle palpation procedures: the efficacy of a calibration program.

The purpose of this study is to assess the muscle palpation interexaminer agreement after a calibration program and to determine differences between time, groups of muscles, or side examined. A sample of 32 individuals, matched for sex, was divided into two groups: symptomatic (16 patients presenting with myogenic TMD) and asymptomatic (16 subjects with no TMD symptoms). Palpation procedures were performed three different times by four calibrated examiners, in masticatory and cervical muscles. The presence or severity of tenderness was judged by an ordinal scale (from "0" to "3"). Kendall's concordance test measured agreement between examiners. The sternocleidomastoid muscle showed the highest agreement (0.84), while the worst result was detected for the origin of the masseter (0.56). Levels of agreement for all muscles were considered fair and excellent, regardless of the time of examination or the side analyzed.

Calibration↗
PubMed2003

Changes in head position due to occlusal supporting zone loss during clenching.

To establish the relationship between the condition of the stomatognathic system and body posture, changes in the head position during clenching were observed and investigated when the occlusal supporting zone was lost unilaterally and bilaterally. The results were as follows: 1. Regardless of the occlusal conditions, the head position was changed by clenching; 2. The occlusal conditions did not affect the changed distance of the head position; 3. The head position was changed forward and down by clenching regardless of the condition of the occlusal supporting zone. The head position changed more laterally to the opposite side of the lost occlusal supporting zone by clenching with the occlusal supporting zone lost unilaterally rather than bilaterally. Based on this study, it is suggested that unilateral loss of the occlusal supporting zone may cause the neck muscles to become inharmonious and thus affect body posture.

Adult↗
PubMed2001

Women at work despite ill health: diagnoses and pain before and after personnel support. A prospective study of hospital cleaners/home-help personnel with comparison groups.

The present study sought to elicit the diagnoses behind the pain conditions causing complaints by female hospital cleaners and home-help personnel who were working despite their symptoms. We also wished to describe the prevalence of musculoskeletal diagnoses and the intensity, frequency and location of pain, and changes in the clinical picture and pain after personnel supporting interventions. A prospective study was carried out with intervention groups and non-randomized comparison groups. The hospital cleaners intervention programme comprised occupational organizational measures, competence development, physical and psychosocial working environmental measures and individual and rehabilitation measures on both an individual and a group basis. The home-help programme comprised a 2-week stay at an orthopaedic rehabilitation unit, training of supervisors, comrade massage, purchase of training equipment and stress management. Myalgia/ tendinitis occurred in 61% of shoulder girdle elevators, 18% of rotator cuffs, 16% of dorsal neck muscles and 29% of hip muscles. There was musculoskeletal pain in the lower back in 28% of cases. Referred pain from a musculoskeletal focus occurred in about one-sixth to one-third of individuals with the diagnosis in question. Neurogenic pain occurred in 6% of cases. No fibromyalgia syndrome was found. One-third of individuals felt pain all the time or almost all the time. The mean rated perceived "worst pain" was 70 mm on a visual analogue scale of 1-100 mm. Comparisons between intervention and reference groups indicated that some improvement in the clinical picture can be attained using this kind of general support programme for employees.

Adult↗
PubMed2005

Smooth pursuit neck torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety.

OBJECTIVE: The smooth pursuit neck torsion test is thought to be a measure of neck afferent influence on eye movement control and is useful in assessing subjects with whiplash, especially those complaining of dizziness. Nevertheless, it is not known whether impairments identified relate only to abnormal cervical afferentation or are influenced by levels of anxiety or neck pain. DESIGN: A prospective, 3-group, observational design. SUBJECTS: One hundred subjects with persistent whiplash (50 complaining of dizziness, 50 not complaining of dizziness) and 50 healthy controls. METHODS: The smooth pursuit neck torsion test was performed and analysed taking into account subjects' reported levels of pain, anxiety and dizziness. RESULTS: The results confirm that there are significant (p<0.01) differences in the smooth pursuit neck torsion test between subjects with persistent whiplash both with dizziness (mean 0.11) and without dizziness (mean 0.07) compared with healthy control subjects (mean 0.01). The results suggest that the test is not influenced by a patients' level of anxiety, but may be influenced by both nocioceptive and proprioceptive factors. CONCLUSION: The results provide further evidence of the usefulness of the smooth pursuit neck torsion test to identify eye movement disturbances in patients with whiplash, which are likely to be due to disturbed cervical afferentation.

Adult↗