Unilateral or “Side-Locked” Migrainous Headache With Autonomic Symptoms Linked to Night Guard Use

Authors

  • Jean Strahlendorf PhD,

    1. From the Texas Tech University Health Sciences Center—Cell Physiology and Molecular Biophysics, Lubbock, TX (J. Strahlendorf); Texas Tech University Health Sciences Center—Neuropsychiatry and Behavioral Neurosciences, Lubbock, TX, USA (R. Schiffer and H. Strahlendorf).
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  • Randolph Schiffer MD,

    1. From the Texas Tech University Health Sciences Center—Cell Physiology and Molecular Biophysics, Lubbock, TX (J. Strahlendorf); Texas Tech University Health Sciences Center—Neuropsychiatry and Behavioral Neurosciences, Lubbock, TX, USA (R. Schiffer and H. Strahlendorf).
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  • Howard Strahlendorf PhD

    1. From the Texas Tech University Health Sciences Center—Cell Physiology and Molecular Biophysics, Lubbock, TX (J. Strahlendorf); Texas Tech University Health Sciences Center—Neuropsychiatry and Behavioral Neurosciences, Lubbock, TX, USA (R. Schiffer and H. Strahlendorf).
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  • Conflict of Interest: None

J. Strahlendorf, PhD, Texas Tech University Health Sciences Center—Cell Physiology and Molecular Biophysics, 3601 4th Street, Stop 6551, Lubbock, TX 79430, USA

Abstract

Night guards are commonly prescribed as a palliative measure for bruxism, temporomandibular joint symptoms, and associated disorders. We describe a patient with a 10- to 12-year history of night guard use with concurrent unilateral side-locked migrainous headaches with autonomic symptoms characteristic of trigeminal autonomic cephalgia. These headaches were refractory to numerous pharmacological interventions. Upon self-initiated cessation of night guard use, there was complete remission of headaches. We believe the headaches were initiated by night guard-initiated irritation of the trigeminal nerve and a trigeminal autonomic reflex resulting in unilateral migrainous headache with autonomic signs.

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