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Tetanus, caused by , is a significant health problem, particularly in regions lacking proper vaccination coverage against tetanus. Although it is usually associated with an identifiable wound, diagnosing tetanus without a visible entry site can be difficult. We report a 68-year-old man who was diagnosed with tetanus without any visible wounds or recent trauma.

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CEPHALIC TETANUS: A CASE REPORT AND REVIEW OF LITERATURE.

West Afr J Med

November 2024

Paediatric Infectious Diseases Unit, Department of Paediatrics, Jos University Teaching Hospital/University of Jos, Jos, Plateau State, Nigeria.

Summary/introduction: Cephalic tetanus (CT) constitutes only 1-3% of total reported tetanus cases. It is marked by flaccid paralysis of one or more cranial nerves (CN) with or without spasticity, typically following craniofacial injuries. The facial nerve is the most frequently paralyzed.

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This clinical record revisits the classical and pathognomonic features of craniocervical tetanus in a 65-year-old farmer who presented with acute-onset trismus, multiple cranial nerve pareses (III, IX, and X), risus sardonicus, and spasm of the head-neck musculature. This paper explores the relevant literature and presents a brief pictorial analysis of the global epidemiologic data. With most countries successfully adopting the maternal and neonatal tetanus elimination (MNTE) program, the incidence and mortality of tetanus across age groups have sharply reduced in high-income and most middle-income nations.

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An 11 years old male Labrador cross presented with unilateral vestibular signs, ipsilateral facial paresis, moderate obtundation, ptyalism, and paraparesis. MRI of the brain revealed diffuse, multifocal T2/FLAIR hyperintense changes throughout various regions of the brain including the medulla, midbrain, pons, thalamus and right cerebral hemisphere with mild multifocal contrast enhancement. The patient progressed to trismus with generalized increased extensor tone and risus sardonicus.

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