Asymmetry in jaw-jerk reflex latency in craniomandibular dysfunction patients with unilateral masseter pain.

The purpose of the present study was to elucidate the effects of unilateral masseter muscle pain on the jaw-jerk reflex. The latency and peak-to-peak amplitude of bilateral electromyographic activity recorded at the masseter muscles during the jaw-jerk reflex were measured in 18 patients with craniomandibular dysfunction (CMD) with strictly unilateral masseter pain or tenderness and 10 control subjects using a computerized recording and analysis system. The reflex was elicited, at the mandibular rest position, by tapping the centre of the chin downwards with a reflex hammer incorporating a microswitch that triggered the sweep of the recording apparatus upon contact with the chin. In the CMD group, the jaw-jerk latency on the affected side (6.89 +/- 0.98 ms) was significantly shorter (P < 0.01) than that on the unaffected side (7.59 +/- 0.92 ms). In the control group, there was no difference between the jaw-jerk latencies on the right (7.06 +/- 0.64 ms) and the left (7.08 + 0.65 ms) sides. The range of side asymmetry for jaw-jerk latencies in the CMD group was greater than that in the control group. In six patients, the latency difference exceeded 1 ms. The asymmetry of latency of the jaw-jerk reflex was thought to be due to facilitation on the side with masseter pain or tenderness. This facilitation on the ipsilateral side might be produced by enhanced gamma drive induced by sustained nociceptive stimulation. Such effects may be related with clinically derived concepts regarding such muscle dysfunction as myospastic activity or trigger points.