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The stapedial reflex in cephalic tetanus
C de Souza1, D Karnad, R de Souza
1Department of Medicine, KEM Hospital, Parel, Bombay, India.
The Journal of Laryngology and Otology
|September 1, 1994
Summary
Cephalic tetanus, a rare form of tetanus affecting facial nerves, can manifest with bilateral VIIth cranial nerve involvement. Serial stapedial reflex testing proved crucial for monitoring patient recovery or deterioration.
Area of Science:
- Neurology
- Infectious Diseases
- Otolaryngology
Background:
- Cephalic tetanus is a rare but serious complication of head and facial injuries.
- It can lead to significant neurological deficits, including cranial nerve palsies.
Purpose of the Study:
- To present three cases of cephalic tetanus with detailed neurological involvement.
- To highlight the utility of serial stapedial reflex testing in managing cephalic tetanus.
Main Methods:
- Case series presentation of three patients with cephalic tetanus.
- Clinical assessment of cranial nerve involvement, including bilateral VIIth cranial nerve.
- Serial electrophysiological testing of the stapedial reflex.
Main Results:
- All patients exhibited bilateral VIIth cranial nerve (facial nerve) involvement, with initial weakness progressing to hyperactivity.
- One patient also presented with concurrent IIIrd, IVth, and VIth cranial nerve palsies.
- Stapedial reflex activity preceded facial muscle involvement and served as a reliable indicator of disease progression or improvement.
Conclusions:
- Cephalic tetanus can present with complex bilateral cranial nerve involvement.
- Stapedial reflex testing is a valuable tool for monitoring therapeutic response and predicting outcomes in cephalic tetanus.