Misleading bilateral blink reflex loss in a severe tetanus case

Area of Science:

• Neurology
• Infectious Diseases

Background:

• Tetanus is a rare disease often overlooked in diagnostics.
• Diagnosis relies heavily on clinical symptoms due to a lack of sensitive paraclinical tests.

Observation:

• A case of severe tetanus presented with a missing bilateral blink reflex.
• This neurological sign was initially considered potentially confounding.

Findings:

• The absence of a bilateral blink reflex can be a feature of severe tetanus.
• This finding does not exclude the diagnosis of tetanus.

Implications:

• Clinicians should consider tetanus in the differential diagnosis even with atypical neurological presentations.
• The blink reflex should be interpreted cautiously in suspected tetanus cases.
• Further research into sensitive diagnostic markers for tetanus is warranted.