Ann Rehabil Med.  2012 Feb;36(1):167-170. 10.5535/arm.2012.36.1.167.

A Case of Cephalic Tetanus with Unilateral Ptosis and Facial Palsy

• Seo DH
• Cho DK
• Kwon HC
• Kim TU

• KMID: 2266798
• DOI: http://doi.org/10.5535/arm.2012.36.1.167

Abstract

Cephalic tetanus is defined as a combination of trismus and paralysis of one or more cranial nerves. Cranial nerves III, IV, VI, VII, and XII may be affected, but the facial nerve is most frequently implicated. A 64-year-old female visited hospital for left ptosis followed by facial palsy after a left forehead abrasion in a car accident. At nine days post injury, left ptosis developed, left facial palsy developed twelve days post injury, and at fifteen days post injury, trismus and dysphagia developed. The following day, there was progression of symptoms to generalized tetanus, such as dyspnea and generalized rigidity. Videofluoroscopic swallow study showed penetration and aspiration. We report a case of cephalic tetanus with ptosis, facial palsy, and dysphagia, which progressed to generalized tetanus.

Keyword

Cephalic tetanus; Ptosis; Facial palsy

MeSH Terms

Cranial Nerves
Deglutition Disorders
Dyspnea
Facial Nerve
Facial Paralysis
Female
Forehead
Humans
Middle Aged
Paralysis
Tetanus
Trismus

Figure

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  Fig. 1 (A) Wound scar (arrow) on the left forehead. (B) Ptosis and facial palsy on the left side.

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  Fig. 2 Videofluoroscopic Swallow Study. (A) Lateral view shows laryngeal penetration (arrow). (B) Follow-up study does not show laryngeal penetration.

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