Dislocation temporo-mandibulaire bilatérale survenue lors d’une éclampsie

Abstract

The dislocation of the temporomandibular joint (TMJ) is defined as the permanent loss and more or less complete loss of normal anatomical relationships between temporal condyles and mandibular ones. Risk factors predisposing to these dislocations are known and include conditions such as dimorphism, the unit's syndrome algo-dysfunctional mastication and history of dislocation. These dislocations occur most often after an effort to yawn or in cases of willful forced opening mouth. A female predominance is found in the literature, and may be related, first to a loosening of the ordinary ligament because of the hormonal impregnation and secondly to a hormonal contraceptive treatment that increase the likelihood of a malfunction of the TMJ. A case of dislocation in a parturient screaming pain during a vaginal delivery has already been published in the literature. We report a rare circumstance of occurrence of this complication: a dislocation of TJM during an eclampsia occurring at 32 weeks. This was discovered in post extubation after appropriate management of eclampsia who was delivered by caesarean under general anesthesia: the review did not reveal TMJ dislocation in past history but a blocked opening of the mouth, an impossibility dental occlusion and emptiness of both temporal glenoid on the scanner. The dislocation was reduced manually sedated with propofol. A bandage immobilization of the joint has been established for a few days with a good clinical and functional outcome.

Pan African Medical Journal 2016; 23