Neurotetanus

Neurotetanus is a severe neurological complication of tetanus, a disease caused by the toxin produced by the bacterium *Clostridium tetani*. While tetanus primarily affects the nervous system, neurotetanus specifically refers to the neurological manifestations that arise when the tetanospasmin toxin reaches the central nervous system. The toxin disrupts inhibitory neurotransmission, leading to uncontrolled muscle contractions and spasms.

Symptoms of neurotetanus typically begin with localized muscle stiffness, often in the jaw (trismus or "lockjaw"), followed by generalized rigidity and spasms. These spasms may be triggered by sensory stimuli such as noise, light, or touch. Over time, the condition can progress to severe complications, including respiratory failure due to diaphragmatic spasms, autonomic dysfunction (such as irregular heart rate or blood pressure), and even death if untreated.

The disease is acquired through contamination of wounds with *Clostridium tetani* spores, which release the toxin under anaerobic conditions. Neurotetanus is rare in vaccinated populations but remains a significant risk in areas with low vaccination coverage. Prevention relies on immunization with tetanus toxoid, proper wound care, and administration of tetanus immune globulin in high-risk cases.

Treatment involves supportive care, including muscle relaxants, sedation, and mechanical ventilation if respiratory function is compromised. Antitoxin therapy can neutralize circulating toxin, but it does not reverse existing neurological damage. Antibiotics, such as metronidazole or penicillin, may be used to eliminate the bacterial source, though their effectiveness in altering the course of established neurotetanus is limited. Prognosis depends on the severity of symptoms and the speed of intervention, with mortality rates historically high in untreated cases.