What is Opisthotonus: Symptoms, Causes, Treatments

What is Opisthotonus or Opisthotonos?

Opisthotonus, also known as opisthotonos, is a state of severe hypertension and spasticity where an individual’s head, neck and the spinal columns enter in to a complete arching or bridging position. This abnormal posturing is an extrapyramidal effect and is primarily caused by spasm of axial muscles and the spinal column. In case an individual with opisthotonus lies on his or her back then only the back of the head and the heels touch the supporting surface.

This condition is more common in infants and children than in adults. It is also more exaggerated in infants and children, as they have a less mature nervous system.
There are treatments available for addressing the underlying causes of opisthotonus and also there are some preventive measures you can take so as to avoid the condition. More about the causes, symptoms and treatments are discussed below in the article.

What is Opisthotonus or Opisthotonos?

Symptoms of Opisthotonus

  • A severely arched back is a common symptom of opisthotonus.
  • Heels and head are bent back to an extreme degree in people suffering from opisthotonus.
  • Hands and arms move around in a stiff manner.
  • There may be spasms that can come on all of a sudden or may occur repeatedly.
  • There may also be a reduced brain function associated with opisthotonus.

Causes of Opisthotonus

Usually opisthotonus occur in infants who have meningitis. This condition may also occur as a sign of reduced brain function or an injury to the nervous system. Let us know more about the causes of opisthotonus:

  • A problem with the brain structure or Arnold-Chiari Syndrome
  • Brain tumor.
  • Gaucher disease.
  • Occasionally Growth hormone deficiency may be the cause of opisthotonus.
  • Krabbe disease.
  • Glutaric aciduria and organic acidemia are the forms of chemical poisoning.
  • Seizures.
  • Severe head injury can also be a cause of opisthotonus.
  • Serious imbalance in electrolyte.
  • Tetanus.
  • Bleeding in the brain or subarchnoid hemorrhage.
  • Stiff person syndrome.

In rare case some drugs like phenothiazines and other antipsychotic medications may cause a side effect known as acute dystonic reaction. Opisthotonus may be a part of this reaction.

In rare cases, babies born to women who drink adequate amounts of alcohol during pregnancy may have opisthotonus.

Opisthotonus may also be caused because of an Adrenergic bronchodilator overdose, or when you inhale too much of medication, may be due to misuse of a bronchodilator, the inhalers that treat asthma and chronic cases of bronchitis.

Diagnosis and Tests of Opisthotonus:

You need to consult with your doctor if you have opisthotonus. You will have to undergo general physical examination and other tests before your treatment. Below are some of the tests and diagnosis you can expect in a doctor’s chamber.

  • The doctor will take a medical history of yours and perform physical examination so as to look after the cause of your condition.
  • There may be tests conducted which may include blood and urine tests, CSF or cerebrospinal fluids culture and cell counts.
  • CT Scan of the head would be required.
  • Electrolyte analysis would be done.
  • MRI of the brain would be required.
  • Lumbar puncture or spinal tap would be done.

Treatment for Opisthotonus

Before we talk about the treatments, we must mention that the treatment for opisthotonus depends on treating the underlying condition.

  1. Treatment of Opisthotonus Caused Due to Bacterial Meningitis:

    The doctor will treat bacterial meningitis with antibiotics. The viral form of the condition is generally treated with OTC pain relievers, bed rest and fluids.

  2. Treating Opisthotonus Caused Because of Arnold-Chiari Syndrome:

    Here, treatments depend on the severity of the malformation. Surgery is most likely required to correct more symptomatic and advanced malformations.

    A shunt can be used to drain the liquid and relieve pressure, in case the affected child or the person has excess of fluid in the brain.

  3. Treatment of Opisthotonus Caused Due to Tetanus:

    Though tetanus cannot be cured, medications can help relieve symptoms. Usually the treatments involve the following:

    • Cleaning the wound so as to keep the infection from spreading.
    • Antibiotics for killing the bacteria.
    • Tetanus anti-toxin injections for reducing the impact of the infection.

    It must be mentioned that your child may require supportive care. For example, in case of severe tetanus, it can affect the muscles a child requires to breathe. In such a case, the doctor may use a ventilator for helping the child with breathing.

  4. Treating Opisthotonus Due to Bleeding in Brain:

    Here, surgery would be required to fix the cause. The surgery will also relieve pressure on the brain and also prevent permanent brain damage.

  5. Treatments for Opisthotonus Caused Due to Bronchodilator Overdose:

    Intravenous Fluid may be required to counteract the bronchodilator overdose. By treating this, opisthotonus could be cured.

Prevention of Opisthotonus:

You can reduce the risk of having opisthotonus by taking following steps to prevent the underlying causes of it.

Meningitis Prevention:

You can reduce the risk of your child of getting meningitis through frequent hand washing and staying away from others who have this illness. Vaccines can also protect your child from some forms of bacterial meningitis.

Subarachnoid Hemorrhage Prevention:

Treating aneurysms promptly may reduce your child’s risk of subarachnoid hemorrhage.

Prevention of Tetanus:

Vaccines may help in preventing tetanus infections. Make sure that your child follows the recommended vaccine and booster schedule for complete immunization.


With all the above information about the causes, symptoms, treatments and preventive measures for opisthotonus, it might be now easier for you to keep self and your child protected against the condition. Make sure you go for an immediate consultation with the doctor in case you experience the symptoms of opisthotonus and get treated at the best.

Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:April 5, 2018

Recent Posts

Related Posts