Abadie V, Chéron G, Madjiidi A, Couly G
Département de pédiatrie, Hôpital des Enfants-Malades, Paris, France.
Arch Pediatr. 1994 Jun;1(6):568-72.
Trismus is caused by sustained contraction of the jaw-closing muscles. It is rare in the neonate and can be a part of developmental defects.
Twenty-four neonates, aged 1 to 12 days, were admitted from 1980 to 1992 because they suffered from trismus. All of them had severe difficulties of sucking and/or swallowing, some (12/24) had repeated episodes of apnoea requiring tracheotomy. Specialized investigations included transcutaneous PO2 and PCO2 monitoring, polygraphic recordings during sleep, 24-hour Holter monitoring, ocular compression test, barium swallow, manometry and 24-hour pH monitoring of the distal esophagus, electromyography of muscles involved in swallowing and several imaging techniques.
Twenty-one patients had anomalies of the facies and brain stem dysfunctions. They were classified as Robin sequence (14 patients) with (five patients) or without (nine patients) micrognathia, cleft palate and glossoptosis, as Hanhart syndrome (four patients) and Moebius syndrome (three patients). The last three patients had arthrogryposis (two patients) and Stuve-Wiedeman syndrome. Twenty-two of 24 patients had severe gastroesophageal reflux, 15 of 20 had increased vagal reactivity and five of 24 had anomalies of the central nervous system. Eight patients died during the first year of life.
Neonatal trismus is a poor prognostic sign, requiring specialized investigations and frequently resuscitation techniques.
牙关紧闭是由闭口肌持续收缩引起的。在新生儿中较为罕见，可能是发育缺陷的一部分。
1980年至1992年间收治了24例年龄在1至12天的新生儿，他们均患有牙关紧闭。所有患儿均有严重的吸吮和/或吞咽困难，部分患儿（12/24）反复出现呼吸暂停，需要进行气管切开术。专业检查包括经皮氧分压和二氧化碳分压监测、睡眠期间的多导记录、24小时动态心电图监测、眼压迫试验、吞钡检查、测压以及远端食管24小时pH监测、吞咽相关肌肉的肌电图检查和几种成像技术。
21例患儿存在面部异常和脑干功能障碍。他们被分类为罗宾序列征（14例），其中伴有小颌畸形、腭裂和舌后坠的有5例，不伴有上述症状的有9例，汉哈特综合征（4例）和默比厄斯综合征（3例）。最后3例患儿患有先天性多发性关节挛缩症（2例）和施图韦 - 维德曼综合征。24例患儿中有22例存在严重的胃食管反流，20例中有15例迷走神经反应性增强，24例中有5例存在中枢神经系统异常。8例患儿在出生后第一年内死亡。
新生儿牙关紧闭是预后不良的体征，需要进行专业检查并常常采用复苏技术。
