Next Article in Journal
First Evidence of Placental Transfer of Ochratoxin A in Horses
Next Article in Special Issue
Influence of Botulinum Toxin Therapy on Postural Control and Lower Limb Intersegmental Coordination in Children with Spastic Cerebral Palsy
Previous Article in Journal / Special Issue
Off Label Use of Botulinum Toxin in Children under Two Years of Age: A Systematic Review
Open AccessReview

Tetanus: Pathophysiology, Treatment, and the Possibility of Using Botulinum Toxin against Tetanus-Induced Rigidity and Spasms

1
Norwegian Defense Research Establishment, N-2027 Kjeller, Norway
2
Department of Neurology, Oslo University Hospital-Rikshospitalet, 0027 Oslo, Norway
Toxins 2013, 5(1), 73-83; https://doi.org/10.3390/toxins5010073
Received: 26 September 2012 / Revised: 25 December 2012 / Accepted: 27 December 2012 / Published: 8 January 2013
(This article belongs to the Special Issue Clinical Use of Botulinum Toxins)
Tetanus toxin, the product of Clostridium tetani, is the cause of tetanus symptoms. Tetanus toxin is taken up into terminals of lower motor neurons and transported axonally to the spinal cord and/or brainstem. Here the toxin moves trans-synaptically into inhibitory nerve terminals, where vesicular release of inhibitory neurotransmitters becomes blocked, leading to disinhibition of lower motor neurons. Muscle rigidity and spasms ensue, often manifesting as trismus/lockjaw, dysphagia, opistotonus, or rigidity and spasms of respiratory, laryngeal, and abdominal muscles, which may cause respiratory failure. Botulinum toxin, in contrast, largely remains in lower motor neuron terminals, inhibiting acetylcholine release and muscle activity. Therefore, botulinum toxin may reduce tetanus symptoms. Trismus may be treated with botulinum toxin injections into the masseter and temporalis muscles. This should probably be done early in the course of tetanus to reduce the risk of pulmonary aspiration, involuntary tongue biting, anorexia and dental caries. Other muscle groups are also amenable to botulinum toxin treatment. Six tetanus patients have been successfully treated with botulinum toxin A. This review discusses the use of botulinum toxin for tetanus in the context of the pathophysiology, symptomatology, and medical treatment of Clostridium tetani infection. View Full-Text
Keywords: tetanus; tetanospasmin; Clostridium tetani; botulinum toxin; trismus; lockjaw; dysphagia tetanus; tetanospasmin; Clostridium tetani; botulinum toxin; trismus; lockjaw; dysphagia
MDPI and ACS Style

Hassel, B. Tetanus: Pathophysiology, Treatment, and the Possibility of Using Botulinum Toxin against Tetanus-Induced Rigidity and Spasms. Toxins 2013, 5, 73-83.

Show more citation formats Show less citations formats

Article Access Map by Country/Region

1
Only visits after 24 November 2015 are recorded.
Search more from Scilit
 
Search
Back to TopTop