睡眠時ブラキシズムに伴う顎顔面痛に対し，抑肝散が奏効した2例

抄録

Maxillofacial pain is one of the major symptoms of temporomandibular disorders, and bruxism is considered as one of the main causes of temporomandibular disorders. Pathological factors such as stress are thought to increase the incidence of bruxism, and consequently, of temporomandibular disorders. We report two cases in which yokukansan was effective for control of the maxillofacial pain, which was thought to be caused by stress-related sleep bruxism.

Case 1 was a 35-year-old woman who was often stressed by her family and work pressures, and was sometimes told that she exhibited sleep bruxism. She reported to our department with a 6-month history of right mandibular pain. Since the symptom was induced by palpation of the right masseter muscle and was particularly severe in the morning, we diagnosed the pain as arising from the fascia of the masseter muscle due to sleep bruxism. We started her on treatment with yokukansan (7.5 g/day), and the mandibular pain improved by the end of 4 weeks of treatment.

Case 2 was a 53-year-old man who experienced severe stress at work. When he woke up during sleep, he often clenched his teeth. He reported to our department with a one-year history of discomfort and mild pain in the back of ears, temporal region and around the eyes on both sides. Since the symptom was induced by palpation of the sternocleidomastoid muscle and was particularly severe in the morning, we diagnosed the pain as arising from the fascia of the sternocleidomastoid muscle due to sleep bruxism. We started him on treatment with yokukansan (7.5 g/day), and the symptoms improved by the end of 6 weeks of treatment.

Yokukansan is expected to reduce bruxism due to its anti-stress effect and efficacy in reducing chronic pain itself, and is considered to be useful for cases of chronic maxillofacial pain associated with bruxism.