The involvement of cranial muscles in migraine
Clinical findings have determined that pericranial (jaw and neck) muscle tenderness is a common and prominent feature of migraine. In migraineurs there is a marked increase in electromyographic activity in these muscles versus non-migraneurs. Research has shown that the size (volume) of jaw muscles in migraneurs is 70% greater than in non-migraneurs.
A study was conducted on migraineurs who were fitted with an intra-oral palatal appliance. The role of this appliance is to encourage the jaw to assume its rest position and alter the habitual neuromuscular patterns of the “chewing” muscles of the jaw. When the appliance is worn there is increased resting length and relaxation of the craniomandibular muscles.
The Migraine Specific Quality of Life Questionnaire was used to assess the efficacy of the appliance on three dimensions of the patients’ quality of life – role function restriction (%) which assesses the time during which the patient can perform their normal daily duties, role function prevention (%) during which the patient is productive while working, and emotional function (%) during which emotional and relationship disability is measured.
While wearing the appliance which encourages the sternocleidomastoid, masseter and temporalis muscles to relax, role function restriction improved from 54.6 to 91% (p < 0.0001). Role function prevention improved from 45.5 to 84.8% (p < 0.0001) and emotional function improved from 45.5 to 91.2% (p < 0.0001).
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