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Although well established as a neurogenic reflex pursuing a cardiovascular protective control in physiological conditions, trigemino-cardiac reflex (TCR) mechanisms and its clinical significance remains unclear This powerful brainstem oxygen-conserving autonomic reflex usually manifests as sudden onset of hemodynamic changes on heart rate (HR) and blood pressure (BP) and has been associated to arrhytmias, asystole, apnea and disturbed gastric mobility [1]. The automatic response can be activated by mechanical or chemical stimulation at any point in the course of the trigeminal nerve and their branches and usually gets abolished after the removal of the inciting stimulus. Sometimes however persistence of TCR can result in exaggerated response which may have fatal consequences, particularly in pediatric age and in elderly. This is of primary relevance when TCR occur in the chronic form which is largely underestimated and under reported [2]. Though the role of TCR have been investigated in surgical related patho physiological conditions, it was recently admitted that it can have a clear significance in the aim of several sleep disturbances as sudden infant death syndrome (SIDS), obstructive sleep apnea (OSA) and sleep related bruxism (SB) [3]. In a review published in these same issue of OJNBD, Ken Luco looked for establishing a relationship between TCR and Sleep Bruxism, a sleep related movement disorder characterized by transient further recurrent autonomic changes (sympathetic hyper activation) generating tachycardia, tachypnea and hypertension chronologically associated to rhythmic masticatory muscle hyper activation. The better knowledge of the TCR will help us to understand other factors influencing the autonomic modulation during sleep and its association with sleep quality, cardiovascular risk and neurocognitive functioning.

online journal of neurology and brain disorders

About the Trigemino-Cardiac Reflex, their Association with Sleep Bruxism and the Reason Why Clinicians Treating Sb Should Consider a Careful Examination in Order to Decide Properly How to Adequately Follow these Patients