Chewing in patients with severe neurological impairment.
As degenerative disease, infarction and hemorrhage in the CNS may compromise chewing, the aim was to classify and analyse such chewing disturbances. The case series included clinical and electromyographic recordings from 10 patients (ages 12-78 years) with neurological disorders. Classifications were involuntary munching (two women with dystonia which was abolished during mastication), ceased chewing function (three men with impaired volitional motor control and spasticity from locked-in syndrome, restricted chewing range (two men and one woman with reduced jaw opening due to paradoxical activity after brainstem lesions), and distorted chewing pattern (two men with dystonia resulting in blockings during chewing). The effect of the neurological impairment illustrated the complex control of mastication and the interaction between central and peripheral mechanisms, and the variation of the chewing disturbances was surprisingly great, even with similar diagnosis.