Temporomandibular Eklem ve Nöroloji
Özet
Temporomandibular eklem bozukluğu (TMB), çene eklemi ve çiğneme kaslarını etkileyen; ağrı, ses ve hareket kısıtlılığıyla seyreden multifaktöriyel bir tablodur. Bu makalede, TMB’nin nöroloji pratiğindeki sık görülen hastalıklarla ilişkisi incelenmiştir. Polikliniklere başvuru nedenlerinde ilk sırada yer alan başağrısı şikayetlerinde, hastaların önemli bir kısmında TMB saptanmakta ve bu durum sekonder başağrısı olarak sınıflandırılmaktadır. Epilepsi hastalarında ise nöbet esnasındaki kasılmalar, travmalar, diş kayıpları ve antiepileptik ilaçların kemik metabolizmasına olumsuz etkileri nedeniyle TMB riski artış göstermektedir. Parkinson hastalığında, postür değişiklikleri ve bruksizm TME biyomekaniğini bozarak eklem rahatsızlıklarına zemin hazırlamaktadır. Benzer şekilde, Multipl Skleroz (MS) hastalarında serebellar ataksi ve propriyoseptif değişiklikler TMB sıklığını artırırken, inme sonrasında gelişen sensorimotor defisitler de çiğneme kaslarındaki güç kaybı nedeniyle stomatognatik sistemi olumsuz etkilemektedir. Sonuç olarak, kronik nörolojik hastalıklarda TMB varlığının multidisipliner bir yaklaşımla sorgulanması ve diş hekimleri ile nörologların işbirliği yapması, tanı başarısını artırarak hastaların yaşam kalitesini iyileştirmede kritik bir öneme sahiptir.
Temporomandibular disorder (TMD) is a multifactorial condition affecting the jaw joint and masticatory muscles, presenting with pain, joint sounds, and limited movement. This text examines the relationship between TMD and common neurological diseases in neurology practice. Headache is the primary reason for neurology clinic visits, and TMD is detected in a significant portion of these patients, classified as a secondary headache. In patients with epilepsy, the risk of TMD increases due to myotonic contractions during seizures, physical injuries, tooth loss, and the negative effects of antiepileptic drugs on bone metabolism. In Parkinson's disease, postural changes and bruxism disrupt TMJ biomechanics, predisposing patients to joint disorders. Similarly, cerebellar ataxia and proprioceptive changes in Multiple Sclerosis (MS) patients increase TMD prevalence, while sensorimotor deficits following a stroke adversely affect the stomatognathic system due to loss of strength in masticatory muscles. Consequently, evaluating the presence of TMD in chronic neurological diseases through a multidisciplinary approach and fostering collaboration between dentists and neurologists is of critical importance to enhance diagnostic success and improve patients' quality of life.
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