[Treatment strategies for tetanus]

As a result of active immunisation, tetanus has become a rare but still severe neurological disease in the developed world. Despite modern intensive care management, mortality ranges between 20 and 50%. Introduction of mechanical ventilation dramatically reduced mortality; the life-threatening vegetative dysfunctions with cardiovascular instability are now the main reasons for the remaining poor prognosis. This report provides information about clinical features, diagnosis and prophylaxis of the disease and gives an overview of the therapeutic principles of generalized tetanus, focusing on the management of autonomic instability.