Posted by SM on March 01, 2003 at 00:24:29:In Reply to: Bruxism posted by Paul on March 23, 2002 at 19:44:14:
A little more info needed. What was her mean sleep latency on MSLT and the PLM arousal index. I would also like to see a sleep log. Depending on the results of the above I may order diagnostic tests for PLMD/RLS (H/H, Ferritin, Chem 7). Further history needed, does she have diabetes or neuropathy, xs caffeine or other stimulant use. Temporal lobe epilepsy can be associated with bruxism. Does review of the PSG show any epileptorm activity or are the timing of the bruxisms regular and suspcious. Does she have other waking symptoms of temporal lobe epilepsy? I may try taking her off prozac because it may excacerbate PLMD/RLS. I would definately educate her on techniques to reduce RLS/PLMD. Sleep deprived EEG and neuro consult may be indicated. If further history, labs and sleep log did not reveal significant abnormality, I would attempt a trial of therapy. Perhaps an clonazepam at bedtime in addition to stress management and behavioral therapy.