Autonomic dysfunction in severe tetanus: magnesium sulfate as an adjunct to deep sedation

Area of Science:

• Neurology
• Critical Care Medicine
• Pharmacology

Background:

• Severe tetanus presents with significant autonomic nervous system instability and sympathetic crises.
• Traditional management involves central nervous system (CNS) depressants.

Observation:

• A patient with severe tetanus experienced pronounced autonomic instability.
• Continuous intravenous magnesium (Mg) infusion was administered to manage sympathetic crises.

Findings:

• Magnesium infusion effectively controlled sympathetic crises.
• This therapy suppressed catecholamine release.
• Mg infusions alone were insufficient for complete management.

Implications:

• Continuous iv magnesium (Mg) infusion can be a valuable adjunct therapy for managing sympathetic crises in severe tetanus.
• This approach may help mitigate autonomic instability and reduce catecholamine surges.
• Further research is warranted to define optimal protocols for Mg use in tetanus.