Ultrasound and laser Doppler flowmetry assessment of jaw muscle hypertonia in children with cerebral palsy

Abstract

Relevance. Spastic cerebral palsy is one of the most common forms of cerebral palsy, in which muscular hypertonia, including jaw muscles, is present. To date, there is no universal algorithm for muscle hypertonia. The diagnosis is made based on complaints and data from an electromyographic study. This paper describes and proves the rationale for including ultrasound and laser Doppler flowmetry (LDF) in additional diagnostic methods.Material and methods. We examined 84 children with cerebral palsy using ultrasound and LDF to study the state of the mastication muscles. The ultrasound examination determined the structure and thickness of the masseter and temporal muscles and detected trigger points and the infiltration site. LDF was performed both at rest and after an occlusal test, which allows assessing the reserve capacities of the mastication muscles. We compared the received data with a group of healthy subjects of the same age.Results. Ultrasound parameters and LDF data differed from the control group. The ultrasound examination revealed trigger points for the first time without patients’ complaints. Congestion caused by damage to muscle cells is characteristic of the local blood flow in children with cerebral palsy. The results of the occlusal test evidenced the mastication muscle compensation abilities, which clinicians should consider during treatment planning.Conclusion. The received data will help dentists diagnose and treat muscle hypertonia, which will prevent pathology deterioration.