Tushar Patil
Assistant Professor, Department of Neurology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha
Sandeep Iratwar
Associate Professor, Assistant Professor, Department of Neurosurgery, Jawaharlal Nehru Medical College, datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha
Abstract
Background: Facial paresis in hemiparetic stroke leads to a major impairment in masticatory function in these patients. Along with paresis of facial musculature, there is impairment in power of muscles of mastication supplied by trigeminal nerve
Aims and Objectives: to evaluate masticatory function in patients following a stroke with hemiparesis; and to compare masticatory function in patients following an ischemic stroke with those following a hemorrhagic stroke.
Material and Methods: This prospective study was conducted over a period of one year from August 2014 to July 2015. Cases of acute stroke, with hemiparesis and upper motor were included. Patients whose CT Brain shows an infarct were included in group A. Patients whose CT Brain suggestive of a hemorrhage were included in group B. Age and sex matched controls were included in Group C. The assessment of masticatory function was done by needle electromyography of Masseter muscle on the symptomatic side. Follow up of all the patients was done at the end of three months.
Results: During the study period, 200 patients with acute stroke were screened. After applying the predefined inclusion and exclusion criteria, total of 60 patients were selected as cases. Out of these, 30 cases had acute ischemic stroke. Remaining 30 cases had acute hemorrhagic stroke. Age and sex matched 30 controls were included. Among the patients with Ischemic stroke the patient age was [Mean (SD)] 48.33 (17.3) years. Out of 30 ischemic stroke patients, 21 were male and 9 were female. Hypertension was present in 8 patients, Diabetes was present in 8 patients, Metabolic Syndrome was seen in 7 patients, Smoking was present in 7 patients and 7 patients were obese. Both ischemic and hemorrhagic stroke patients had significantly lower amplitudes and higher area of motor unit action potential (MUAP) of masseter muscle compared to controls. They did not differ significantly between groups A and B. there was significant improvement in these parameters at 3 months follow up.
Conclusions: Masseter muscle MUAP analysis is an important parameter for assessment of masticatory function in stroke patients. Furthermore, there is no significant difference in the masticatory dysfunction between patients with ischemic and hemorrhagic strokes.
Keywords: MUAP