de 11,8, 9,6 e 16,3 no grupo com bruxismo e Distúrbios temporomandibulares e de 2,6, 4,8, e 10,4 no controle (Somatização entre os dois grupos p<0,0001 e para dissociação p<0,0001). Os valores em somatização e dissociação foram de 9,6 e 16,3 (grupo experimental p<0,0001) e 4,8 e 10,4 (grupo controle p<0,0001), . Os valores em somatização (6,2, 9,6, 10,7, e 11,8 p=0,0001) e dissociação (10,6,16,4,15,2 e 27,1 p=0,0001) aumentaram no bruxismo mais intensamente que no grupo experimental. Bruxismo, somatisação e dissociação apresentaram correlação positiva. A prevalência de dissociação intensa foi de 16.8%. Conclusão. Os valores em somatização e dissociação nos pacientes com DTMS foram mais altos do que nos controles. As frequências de somatisação e dissociação aumentaram no bruxismo mais intenso. Unitermos ABSTRACTObjective. To assess the frequency of somatisation/dissociation in bruxers and temporomandibular disorders patients, to evaluate the frequencies of somatization and dissociation and to correlates with bruxism Method. We evaluated the the questionnaires for TMDs/ bruxism, clinical examination, the Rief and Hiller´s questionnaire, and the Bernstein and Putnam´s instrument in 137 bruxers (123 female, mean age 35.3) and 31 controls (20 female, mean age 34.9) Sign and symptoms of joint noises, facial or temporomandibular joint pain, tenderness to palpation, difficulties to perform jaw movements, and joint noises were evaluated. Results. Mean scores in bruxism, somatisation and dissociation in bruxers /TMDs were 11. 8, 9.6 and 16.3, and 2,6, 4,8 and 10,4 in the controls. Somatisation and dissociation scores in TMDs and controls were about 9,6 and 16,3 (p=0.0001) and 4,8 and 10,4 (p<0.0001). Scores in somatisation (6,2, 9,6, 10,7, and 11,8; p<0.0001) and dissociation (10,6, 16,4, 15,2, and 27.1; p<0.0001) increased with severer bruxism). Bruxism, Somatisation, and dissociation were positively correlated. The frequency of dissociation was about 16,8. Conclusions. Somatization and dissociation scores in TMD individuals were higher as compared to control ones. The frequencies of somatisation and dissociation increased more severe bruxism, and were positive correlated.

Bruxism is an oral pnenomenon described as a parafunctional activity involving nocturnal and/or diurnal tooth clenching and/or grinding which may cause teeth wearing, fatigue, pain in the muscles and temporomandibular joints and limitations in mandibular movements. Objective: To classify bruxers in four different subgroups. Material and methods: Evaluation of 162 individuals presenting temporomandibular disorders (TMDs) referred consecutively over a period of six years. Chief complaint, history of signs/symptoms and clinical examination were used to gather data. Individuals were classified as TMDs if they were seeking active treatment for the following complaints: pain in the masticatory muscles and/or temporomandibular joints (TMJs), difficulties to perform normal jaw movements, tenderness to palpation of muscle and joints, joint noises and. Patients were classified as mild, moderate, severe and extreme bruxers if they presented 3 to 5, 6 to 10, 11 to 15 or 16 to 25 signs and symptoms of bruxing behavior, respectively. Data was submitted to Chi-square for independence and Fisher’s exact test (p < 0.05). Results: Frequencies of 16.1%, 29.6%, 31.5% and 22.8% of mild, moderate, severe and extreme bruxing behavior were found in this study. Moderate and severe bruxing behavior occurred more frequently than mild and extreme bruxing behavior (p < 0.0001). Conclusion: The four groups of bruxers occurred more or less frequently in this study and mild and extreme bruxing behavior demonstrated the lowest frequencies of such behavior.

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Rev Neurocienc 2013;21(v):p-p original 242 RESUMOObjetivo. Avaliar a frequência de sintomas neuropáticos em indivíduos com neuralgia occipital, enxaqueca e dor de cabeça por tensão muscular e discutir os mecanismos da neuralgia occipital. Método. Critérios para essas dores de cabeça, distúrbios craniomandibulares e bruxismo, exame clinico, e questionários foram usados em 153 pacientes com distúrbios craniomandibulares e bruxismo. Resultados. As idades médias nos grupos foram 37,3±11,7 anos nos pacientes com neuralgia occipital, 36,5±11,8 anos nos pacientes com enxaqueca e 33,0±12,3 anos nos pacientes com dor de cabeça por tensão muscular. As freqüências de dor tipo choque elétrico, dor em pontada, dormência, dor intensa, uma descrição de queimação, uma zona geradora da dor e dor intermitente foram de 54,3%, 77,1%, 34,3%, 100%, 68,6%, 100% e 57,1% respectivamente, nos pacientes com neuralgia occipital; 6,3%, 18,8%, 0%, 100%, 12,5%, 0% e 0%, respectivamente nos pacientes com enxaqueca, 0%, 17.6%, 0%, 18,6%, 0,9%, 0% e 0%, respectivamente nos pacientes com dor de cabeça por tensão muscular. A frequência da maioria dos sintomas neuropáticos esteve presente entre os pacientes com neuralgia mais do que entre os com dor de cabeça por tensão muscular. Conclusões. Os sintomas neuropáticos diferenciam neuralgia occipital de enxaqueca comum e de dor de cabeça por tensão muscular. A dor muito intensa é mais frequente nos pacientes com neuralgia occipital e enxaqueca, mas não se observa frequentemente nos indivíduos com dor de cabeça por tensão muscular. Unitermos. Dor, Neuralgia, Cefaléia comum, Cefaléia Tensional.Citação. Molina OF, Rank RCI, Simião BRH, Torres SMP, Sobreiro MA, Cury SE, Aquilino RN. Neuralgia occipital como uma dor neuropática verdadeira: evidência clínica e neurofisiológica. ABSTRACTObjective. Assess frequency of neuropathic symptoms in occipital neuralgia, migraine and tension-type headache, and discuss mechanism in occipital neuralgia. Method. Criteria for occipital neuralgia, migraine, tension-type headache, craniomandibular disorders, bruxing behavior, clinical examination, and questionnaires were used. Results. Mean ages are 37.3±1.7 years in occipital neuralgia patients, 36.5±11.8 years in migraine patients, and 33.0±12.3 years in tensiontype headache patients. Frequencies of electric shock-like, stabbing or shooting pain, numbness, very intense pain, a burning description, a pain generating zone and intermittent descriptions were 54.3%, 77.1%, 34.3%, 100%, 68.6%, 100%, and 57.1%, respectively in occipital neuralgia patients, 6.3%, 18.8%, 0%, 100%, 12.5%, 0%, and 0%, respectively, in migraine patients; 0%, 17.6%, 0%, 18.6%, 0.9%, 0% and 0%, respectively, in tension-type headache patients. Comparing neuropathic symptoms between occipital neuralgia and migraine, and between occipital and tension-type headache, neuropathic symptoms were present almost exclusively in occipital neuralgia patients. Conclusions. Neuropathic symptoms differentiate occipital neuralgia from migraine and from tension-type head...

Objective. To establish differential diagnosis in patients presenting occipital neuralgia, tension-type headache, and migraine with aura. Method. We analyzed 32 patients with Occipital neuralgia (mean age=38.0; females=75%), 102 with tension-type headache (mean age=33.0; females=92.2%), and 16 with migraine without aura (mean age=37.0; females=56.3%). The specific symptoms of headaches were used in according to International Classification of Headache Disorders (ICHD) in patients with for craniomandibular disorders and bruxing behavior. Results. Occipital neuralgia group presented more nausea (78.1%; p=0.0001), vomiting (62.5%; p=0.0001), photophobia (71.8%; p=0.0001), throbbing (53.1%; p=0.0001), stabbing pain (78.1%; p=0.0001), severe pain (93.7%; p=0.0001), burning (68.8%; p=0.0001), and occipital nerve tenderness (100%; p=0.0001) than tension-type headache group. Occipital neuralgia group showed more stabbing (78.1%; p=0.0001), burning (68.8%; p=0.0005), and occipital nerve tenderness (100%; p=0.0001) than migraine without aura group. Migraine without aura group showed more vomiting (94%; p=0.03) and photophobia (100%; p=0.02) than occipital neuralgia group. Conclusions. Nausea, vomiting, photophobia, throbbing, stabbing, severer pain, a burning description and occipital nerve tenderness, better differentiated occipital neuralgia from tension-type headache. Stabbing pain, burning and occipital nerve tenderness, better differentiated occipital neuralgia from migraine without aura.

RESUMOObjetivo. Avaliar dor local e referida na neuralgia occipital. Método. Avaliação de prontuários de 32, 16 e 102 pacientes com neuralgia occipital, enxaqueca sem aura e enxaqueca tensional. Critérios para distúrbios craniomandibulares, bruxismo, dores de cabeça, questioná-rios e exame clinico. Resultados. As áreas mais frequentes de dor local e referida na neuralgia occipital foram as regiões temporal, frontal, occipital, sub-occipital, retro-orbitária, cervical e vertex (78,1%). Áre-as mais frequentes de dor local/referida na cefaleia tensional foram as regiões temporal e frontal bilateral em 65 pacientes (63,7%) e as regiões cervical, vertex, sub-occipital e parietal (21,6%). Áreas comuns de dor local e referida na cefaleia sem aura foramnas regiões temporal anterior direita, parietal e occipital, temporal anterior esquerda, parietal, frontal e cervical (62,5%). A mediana de zonas anatômicas com dor foram para neuralgia occipital 3,5; enxaqueca tensional 2,0; enxaqueca sem aura 2,0 e controles 0,5 (Kruskal-Wallis p<0,0001). Conclusão. A dor na neuralgia occipital foi mais difusa e mais locais anatô-micos foram relatados. A dor na enxaqueca sem aura foi menos difusa que na neuralgia occipital e mais difusa que na enxaqueca tensional a qual foi mais localizada, bilateral nas regiões temporal e frontal.Unitermos. Dor, Neuralgia, Cefaleia Comum, Cefaleia Tensional Citação. Molina OF, Santos ZC, Simião BR, Torres SMP, Marçal RL, Penoni VB. A dor é mais difusa e referida para áreas do trigêmeo na neuralgia occipital. ABSTRACTObjetctive. Evaluate local and referred pain in occipital neuralgia. Method. Charts review of 32 occipital neuralgia, 16 migraine without aura and 102 tension-type headache individuals, respectively. Criteria for craniomandibular disorders, bruxism, headaches. Questionnaires to assess pain sites and descriptors for headaches. Results. Common areas of local/referred pain in occipital neuralgia were the temporal, frontal, occipital, sub-occipital, retro-orbital, cervical and vertex (78.1% cases). Common areas of referred pain in tension-type headache were located in the bilateral temporal and frontal areas (65=63.7%). Other areas of referred pain in tension-type headache were the cervical, vertex, sub-occipital and parietal areas (21.6%). Common areas of local and referred pain in migraine (62.5%) were located in the right anterior temporal area, right anterior temporal, parietal and occipital, left anterior temporal and parietal area, frontal and cervical areas. The median of painful anatomic zones were occipital neuralgia 3.5, tension-type headache 2.0, migraine 2.0; and Controls 0.5 (Kruskal-Wallis statistics with post-test p<0.0001). Conclusions. Pain in occipital neuralgia was reported in a more widespread anatomic area and in more anatomic zones as compared to migraine and tension-type headache. The latter was reported usually bilaterally in the frontal and temporal areas.

Objective. To assess the frequency of somatisation/dissociation in bruxers and temporomandibular disorders patients, to evaluate the frequencies of somatization and dissociation and to correlates with bruxism Method. We evaluated the the questionnaires for TMDs/ bruxism, clinical examination, the Rief and Hiller´s questionnaire, and the Bernstein and Putnam´s instrument in 137 bruxers (123 fe­male, mean age 35.3) and 31 controls (20 female, mean age 34.9) Sign and symptoms of joint noises, facial or temporomandibular joint pain, tenderness to palpation, difficulties to perform jaw movements, and joint noises were evaluated. Results. Mean scores in bruxism, soma­tisation and dissociation in bruxers /TMDs were 11.8, 9.6 and 16.3, and 2,6, 4,8 and 10,4 in the controls. Somatisation and dissociation scores in TMDs and controls were about 9,6 and 16,3 (p=0.0001) and 4,8 and 10,4 (p<0.0001). Scores in somatisation (6,2, 9,6, 10,7, and 11,8; p<0.0001) and dissociation (10,6, 16,4, 15,2, and 27.1; p<0.0001) increased with severer bruxism). Bruxism, Somatisation, and dissociation were positively correlated. The frequency of disso­ciation was about 16,8. Conclusions. Somatization and dissociation scores in TMD individuals were higher as compared to control ones. The frequencies of somatisation and dissociation increased more se­vere bruxism, and were positive correlated.

Objetctive. Evaluate local and referred pain in occipital neuralgia. Method. Charts review of 32 occipital neuralgia, 16 migraine with­out aura and 102 tension-type headache individuals, respectively. Criteria for craniomandibular disorders, bruxism, headaches. Ques­tionnaires to assess pain sites and descriptors for headaches. Results. Common areas of local/referred pain in occipital neuralgia were the temporal, frontal, occipital, sub-occipital, retro-orbital, cervical and vertex (78.1% cases). Common areas of referred pain in tension-type headache were located in the bilateral temporal and frontal areas (65=63.7%). Other areas of referred pain in tension-type headache were the cervical, vertex, sub-occipital and parietal areas (21.6%). Common areas of local and referred pain in migraine (62.5%) were located in the right anterior temporal area, right anterior temporal, parietal and occipital, left anterior temporal and parietal area, frontal and cervical areas. The median of painful anatomic zones were occipi­tal neuralgia 3.5, tension-type headache 2.0, migraine 2.0; and Con­trols 0.5 (Kruskal-Wallis statistics with post-test p<0.0001). Conclu­sions. Pain in occipital neuralgia was reported in a more widespread anatomic area and in more anatomic zones as compared to migraine and tension-type headache. The latter was reported usually bilaterally in the frontal and temporal areas.