Dr. Shrushti Dalal* and Dr. Yashesh Dalal (M.B.B.S, M.S General Surgery, M.Ch)


In a minute number of cases of tetanus, a cranial nerve palsy is evident, either as a presenting sign or developing later in the course of the disease. This variant is called cephalic tetanus. Cephalic tetanus is an uncommon form of tetanus defined as trismus plus paralysis of one or more cranial nerves. The most frequently involved cranial nerve is the seventh. It accounts for 1 to 3% of the total number of reported cases of tetanus and has a mortality of 15 to 30%. The incubation period is found to be approximately 1 to 14 days, and nearly two thirds of cases progress to generalized tetanus. The mechanism of the paralysis is not completely understood. Its features have been variously described as comprising causative injury to the head, face or neck, dysphagia, and cranial nerve palsy with or without signs of more generalized tetanus. Treatment involves debridement of wounds, administration of penicillin and tetanus immune globulin, aggressive supportive care, and initiation of active immunization. We report the case of a 20 year old tribal Asian male, who presented with cranial tetanus which progressed to generalised tetanus.

Keywords: Tetanus, Cephalic Tetanus, Tetanospasmin, Facial nerve palsy.

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