---
title: "Botulinum Toxin Type A for Post‑Stroke Bruxism After Left Basal Ganglia Hemorrhage"
id: "pubmed-42855873"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42855873"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42855873/"
doi: "10.12659/AJCR.953163"
published_at: "2026-10-10T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Botulinum Toxin Type A for Post‑Stroke Bruxism After Left Basal Ganglia Hemorrhage
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42855873
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42855873/)
- **DOI:** [10.12659/AJCR.953163](https://doi.org/10.12659%2FAJCR.953163)
- **Published At:** 2026-10-10T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Post‑stroke **bruxism** can impair oral function, cause orofacial pain, and hinder rehabilitation; it is underrecognized in stroke survivors. - The case reports a 40‑year‑old man who developed new‑onset bruxism during recovery from a massive left hemispheric intracerebral hemorrhage after decompressive craniectomy and hematoma evacuation. - Clinical findings included bilateral **masseter** hypertrophy, tenderness on palpation, temporomandibular joint pain, dental wear, and drooling from the right mouth corner. Caregivers reported nocturnal grinding. - The Standardized Tool for the Assessment of Bruxism (**STAB**) was used as a structured, multidimensional assessment framework with subject-, clinical-, and instrument‑based axes (Axis A). Surface electromyography confirmed increased masseter activity at rest and during clenching and was used to guide injections. - Symptoms were refractory to conservative management including occlusal splint therapy and hot compresses. - Electromyography‑guided intramuscular injection of **botulinum toxin type A (BoNT‑A)** was administered to bilateral masseters: 50 U per side, divided into three injection sites per side. - At 48 hours postinjection there was marked reduction in muscle tension and tenderness; clinical improvement persisted at 6‑month follow‑up. - The report is a single‑case, descriptive observation; findings have limited generalizability and controlled studies are needed to establish efficacy and safety of BoNT‑A for post‑stroke bruxism. - MeSH indexing highlights basal ganglia hemorrhage complications, botulinum toxins type A (administration, dosage, therapeutic use), bruxism (etiology, drug therapy), intramuscular injections, and masseter muscle involvement.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Geriatric Rehabilitation, Ningbo Rehabilitation Hospital, Ningbo Key Laboratory of Brain Cognitive Rehabilitation, Ningbo, Zhejiang, China. * 2 Department of Equipment, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang, China. * PMID: **42855873** * DOI: [ 10.12659/AJCR.953163 ](https://doi.org/10.12659/ajcr.953163) Item in Clipboard Case Reports # Case Report: Botulinum Toxin Type A Injection for Bruxism Following Left Basal Ganglia Hemorrhage Jialing Wang et al. Am J Case Rep. 2026. Show details Display options Display options Format Abstract PubMed PMID Am J Case Rep Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Am+J+Case+Rep%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Am+J+Case+Rep%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42855873/) . 2026 Oct 10:27:e953163. doi: 10.12659/AJCR.953163. ### Authors [Jialing Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+J&cauthor_id=42855873)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42855873/#short-view-affiliation-1 "Department of Geriatric Rehabilitation, Ningbo Rehabilitation Hospital, Ningbo Key Laboratory of Brain Cognitive Rehabilitation, Ningbo, Zhejiang, China."), [Xudong Zhu](https://pubmed.ncbi.nlm.nih.gov/?term=Zhu+X&cauthor_id=42855873)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42855873/#short-view-affiliation-2 "Department of Equipment, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang, China."), [Yanjie Fu](https://pubmed.ncbi.nlm.nih.gov/?term=Fu+Y&cauthor_id=42855873)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42855873/#short-view-affiliation-1 "Department of Geriatric Rehabilitation, Ningbo Rehabilitation Hospital, Ningbo Key Laboratory of Brain Cognitive Rehabilitation, Ningbo, Zhejiang, China."), [Ya Zheng](https://pubmed.ncbi.nlm.nih.gov/?term=Zheng+Y&cauthor_id=42855873)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42855873/#short-view-affiliation-1 "Department of Geriatric Rehabilitation, Ningbo Rehabilitation Hospital, Ningbo Key Laboratory of Brain Cognitive Rehabilitation, Ningbo, Zhejiang, China.") ### Affiliations * 1 Department of Geriatric Rehabilitation, Ningbo Rehabilitation Hospital, Ningbo Key Laboratory of Brain Cognitive Rehabilitation, Ningbo, Zhejiang, China. * 2 Department of Equipment, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang, China. * PMID: **42855873** * DOI: [ 10.12659/AJCR.953163 ](https://doi.org/10.12659/ajcr.953163) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract BACKGROUND Post‑stroke bruxism is an underrecognized complication that may impair oral function, cause orofacial pain, and negatively impact rehabilitation outcomes. Botulinum toxin type A (BoNT‑A) has been reported for bruxism, but its application in post‑stroke populations remains sparsely documented. This case describes the assessment and treatment of bruxism following cerebral hemorrhage, utilizing the Standardized Tool for the Assessment of Bruxism (STAB) as a structured multidimensional framework. CASE REPORT A 40-year-old man developed bruxism during recovery from a massive left hemispheric intracerebral hemorrhage after decompressive craniectomy and hematoma evacuation. About 3 months after admission, he began to exhibit bilateral masseter muscle hypertrophy with marked tenderness, temporomandibular joint pain, and drooling from the right mouth corner, with no prior history of bruxism. STAB-based evaluation yielded the following Axis A findings: Subject-based assessment revealed nocturnal grinding reported by caregivers. Clinically based assessment revealed bilateral masseter hypertrophy, tenderness on palpation, and dental wear. Instrument-based assessment (surface electromyography used for injection guidance) confirmed increased masseter muscle activity at rest and during clenching. Symptoms were refractory to occlusal splint therapy combined with hot compresses. At 48 hours after electromyography-guided injection into the bilateral masseter muscles (50 U per side, divided into 3 sites per side), muscle tension and tenderness were markedly reduced, and clinical improvement persisted at 6-month follow-up. CONCLUSIONS In this single case, BoNT‑A injection was temporally associated with symptom relief in post-stroke bruxism. STAB provided a structured multidimensional assessment framework. These descriptive findings have limited generalizability. Controlled studies are needed to establish the efficacy and safety of this intervention in the post‑stroke population. 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