Medullary actions of tetanus toxin. An electrophysiological study in man

Brain-stem reflexes have been studied in four patients with generalized tetanus. Inhibitory cutaneous reflexes were abolished or severely depressed. The same held true, to a lesser degree, for excitatory cutaneous reflexes with long polysynaptic pathways. Proprioceptive reflexes behaved variably. The observations are discussed in regard to the possible sources of enhanced motoneuronal activity in tetanus. It is concluded that, besides depression of inhibitory synapses on motoneurons, interneuronal damage may contribute to the tetanus symptomatology.