• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.345-348
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• 2004

Cephalic tetanus is a rare subtype of tetanus in which trismus is a charateristic symptom. The paralysis of one or more cranial nerves can occur. The 7th cranial nerve is most frequently involved. It account for 1 to 3% of the tetanus and has a mortality of 15 to 30%. The incubation period is 1 to 14 days, and approximately two thirds of tetanus cases progress to generalized tetanus. Generally, the symptoms of cephalic tetanus can include : facial pain, trismus, dysphagia, muscle twitching spasms of the face and jaw (risus sardonicus), neck stiffness and malaise. We present a case of cephalic tetanus who 54-year male patient had trismus and dysphagia. There was no history of trauma. As there was a delay in diagnosis of cephalic tetanus, respiratory disorder and intermittent general spasm occurred. The patient was treated by injection of antibiotics, muscle relaxant, and human anti-tetanus immunoglobulin. His symptoms were disappeared, and he was discharged ambulatory.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.157-160
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• 2010

Tetanus is a life-threatening infection that is rare in the developed country. Because of the rarity: of the disease, the clinician may be unfamiliar with the clinical presentation and unsuspecting of the diagnosis. However, tetanus can rapidly progress into lethal muscle spasms accompanied by respiratory insufficiency, and it has a mortality of 15 to 30%. The most common presenting symptom was trismus, followed by neck pain, dysphagia, generalized pain and facial muscle contractions. Dysphagia is a common symptom of tetanus, but not common as an initial symptom, the correct diagnosis and adequate therapy are likely to be delayed. Treatment involves administration of penicillin, tetanus immune-globulin, debridement of wounds, aggressive supportive care, and initiation of active immunization. We report an elderly woman presenting with dysphagia as an initial symptom of tetanus with review of literature.

• Journal of Oral Medicine and Pain
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• v.36 no.2
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• pp.117-121
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• 2011

Tetanus is fatal neurological disease caused by Clostridium tetani on contaminated wound that is characterised by muscle spasm, muscle pain, and autonomic dysfuction. C. tetani exist on contaminated wound frequently that developed clinical tetanus under low oxygen condition. Tetanus have four symptomatic form: generalized, localized, cephalic, and neonatal. The incubation period is about 7 days and mortality is high. The commonest presenting symptom is trismus and other is stiffness of neck and back(opisthotonos), muscle spasm, dysphagia, facial pain, risus sardonicus. Trismus is primary presenting symptom in 50~75% of the cases and this have high possibility of initial visit to dental office. This case report of a patient who visit in our department with trismus as chief complaint.