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Neuromuscular TMJ Dentistry Case History

Video: Pediatric Migraine Treatment

Patient Description

Male, age 11, student

Principal Complaints

Shy, quiet young boy, was brought in for a consultation by his mother to see if his health problems were perhaps related to TMD. His chief complaints were frequent headaches, mental confusion, petit mal seizures.

Medical History

The patient has been on Trileptal anti-seizure medication for several years which controlled his seizures but did not improve his other symptoms. He started seizure medication at age 4.

Oral Condition

Healthy mouth with all teeth present, good oral hygiene. Very deep bite with retrognathic jaw, accompanied by forward head posture. Osteoarthritic breakdown of left TM joint.


Frequent tension headaches, inability to focus attention for long periods of time, confusion, hyperactivity, petit mal seizures (10 - 12 per day), fatigue, loss of appetite, insomnia, frequent nightmares, limited range of motion in head, neck and shoulders, clenching and grinding of teeth, dizziness, ringing in ears.



Treatment Record

Patient responded very well to treatment with the Gelb MORA (mandibular oral repositioning appliance) and within four months was back to normal. Then he lost his appliance and suffered a small relapse until he received a replacement a few weeks later.

His mother reported that since receiving treatment all of his symptoms have disappeared or improved. The patient has not had a single petit mal seizure since he got his oral appliance.

Before treatment, his mother planned to take him to a neurologist, but now he is healthy and strong. Before treatment, he was a 'scaredy cat', now he is full of confidence.

His appetite is back, he eats like a horse and is hungry all the time. He sleeps well and has no more nightmares. Six months later his maximum opening had increased from 44 mm to 50 mm.

Risto E. Hurme, D.D.S.
Craniofacial Pain and TMJ Disorders
1017 Shook Avenue
San Antonio, TX 78212
(210) 826-4441

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