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What Are The First Signs Of Tetanus?

Tetanus is a bacterial infection, caused by the bacterium clostridium tetani. It exhibits a typical, characteristic feature of muscle spasms. These spasms can last for a few minutes and are seen for almost three to four weeks. These spasms usually start in the jaw first, and then are seen to be progressing to the rest of the body.

What are The First Signs of Tetanus?

What are The First Signs of Tetanus?

The first and foremost of all the sign of tetanus is lockjaw, also known as trismus. Lockjaw is mild spasms of the jaw muscles. However, these spasms may affect the facial muscles so badly that it results in a peculiar condition known as risus sardonicus- wherein the eyebrows are arched, the eyes are wide open, and the mouth is formed into such an appearance that it feels as if the person is grinning in a peculiar way. The person, however, is unaware of this. The chest, stomach, back and buttocks muscles and limbs can be affected. The spasms are so powerful that sometimes they may even cause bone fractures. As the chest muscles can be affected, the breathing can be affected too. When back muscles are involved, they usually cause an arching position known as opisthotonos. It exhibits a characteristic bridging and arching position of the back. These spasms can severely affect breathing and there may be need for manual ventilation.

There are four different types of tetanus- generalized tetanus, neonatal tetanus, local tetanus and cephalic tetanus. They all show some common and some different signs and symptoms.

Generalized Tetanus- the commonest form of tetanus, it presents with almost all of the above general symptoms of tetanus, in a proper descending order. It starts with a lockjaw and the condition risus sardonicus, as mentioned above; then occurs the neck stiffness and the spasm of the muscles involved in swallowing. Then pectoral and calf muscles get affected. Then, there might be symptoms related to heart, like arrhythmia, tachycardia which can be episodic, increased blood pressure. The temperature can be increased and there can be excessive sweating as well. The characteristic arching position or opisthotonos occurs. These spasms last for duration of several minutes and this goes on for almost three to four weeks. Even if the symptoms disappear or reduce after three to four months, the recovery from the disease itself takes several months. If these symptoms are severe in nature, it can result in death, in just a period of 3 to 5 days.

Neonatal Tetanus- it is just another type of generalized tetanus, which occurs in neonates or newborns. Symptoms are almost the same as generalized tetanus. This can happen if a pregnant woman doesn’t get immunized for tetanus during her pregnancy. She can pass the risk factor to her new-born, especially if the umbilical cord cutting is done with unsterile instruments. If a mother is vaccinated against tetanus, she passes passive immunity to her newborn and they generally are not affected.

Local Tetanus- this is a rare form of tetanus, wherein the continuous spasms of the muscles happen only in the area of injury. These spasms may last for several weeks and then they gradually recede. This is comparatively milder than the generalized tetanus and is not that fatal.

Cephalic Tetanus- this is the rarest of all forms of tetanus, wherein the spasms only occur in the muscles of head. This may happen due to some injury to the head, skull fracture, eye injury or even dental extraction. Facial nerve can get paralyzed. Cephalic tetanus can progress to generalized tetanus and is the most fatal of all the tetanus types.

Tetanus is a seriously fatal disease, with death occurring within hours to days. An anti-tetanus shot should never be undermined, and any injury must be reported to the physician and assessed by him. Tetanus is preventable. It is advisable to get oneself immunized by getting anti-tetanus shots once every ten years.


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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 12, 2024

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