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Cephalic tetanus complicating geriatric fall.

Josie McCabe¹, Tessa La Varis, Deborah Mason

¹Department of Medicine, Christchurch Hospital, Christchurch, New Zealand. Josie.Mccabe@cdhb.health.nz.

The New Zealand Medical Journal

|August 23, 2014

Summary

This summary is machine-generated.

Cephalic tetanus can initially present as facial weakness. Early tetanus immunoglobulin (TIG) and vaccination are crucial for preventing this rare but serious condition, especially in older adults.

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Area of Science:

Neurology
Infectious Diseases

Background:

Tetanus is a rare diagnosis in developed countries, but sporadic cases still occur.
Individuals born before 1960 in New Zealand may have lower immunity to tetanus.
Elderly populations are at increased risk due to potentially waning immunity.

Observation:

A case of cephalic tetanus presented initially with acute lower motor neuron facial weakness.
Facial nerve palsy can be an atypical initial symptom of tetanus.

Findings:

Prompt recognition of atypical presentations is key for diagnosis.
Tetanus can manifest with neurological deficits beyond typical symptoms.

Implications:

Judicious use of human tetanus immunoglobulin (TIG) and timely immunisation are vital for preventing tetanus post-injury.
Consider tetanus prophylaxis in elderly patients, particularly those with uncertain vaccination history.
Awareness of cephalic tetanus presentation is important for clinicians managing facial nerve palsies.