J Korean Assoc Oral Maxillofac Surg.
2006 Aug;32(4):380-383.
Tetanus trismus associated with facial eletrical burn
- Affiliations
-
- 1department of OMFS, Hangang Sacred Heart Hospital, Collage of Medicine, Hallym University, Korea.
Abstract
- Tetanus is rare in Korea due to the introduction of vaccination programs and the advancement in public health. Its common signs are trismus, voice disturbance, neck stiffness, and difficulty in swallowing, etc. A 56 years old man was injured by grasping a high voltage electric cable. After the accident, he fell down on a steel plate and had a head trauma. When he visited Emergency Department, there was multiple electric burn wound on left arm and left facial area. He was hospitalized on a department of neurosurgery, because intra cranial hemorrhage was presumed. 12 days later, he was referred to department of OMFS with developed painful masseter spasms and trismus. That night he violently bit his tongue with his denture. Because masseter muscle and temporal muscle constriction was involuntary, tongue was lacerated and denture was distorted. At first we supposed that the symptom was related with neurologic disturbance following head trauma or electric shock. But it was revealed that trismus was caused by tetanus on an electrophysiological test. By using mechanical ventilation and administration of tetanus immunoglobulin, muscle-relaxant, and sedatives at ICU, symptoms had subsided (4-weeks). Because tetanus is rare disease, we rarely suppose tetanus infection to be a cause of a trismus. Especially it is more difficult to diagnose in patient who has head trauma, burn and neurologic problem as in this case.
Keyword
MeSH Terms
-
Arm
Burns*
Burns, Electric
Constriction
Craniocerebral Trauma
Deglutition
Dentures
Emergency Service, Hospital
Hand Strength
Hemorrhage
Humans
Hypnotics and Sedatives
Immunoglobulins
Korea
Masseter Muscle
Middle Aged
Neck
Neurosurgery
Public Health
Rare Diseases
Respiration, Artificial
Shock
Steel
Temporal Muscle
Tetanus*
Tongue
Trismus*
Vaccination
Voice Disorders
Wounds and Injuries
Hypnotics and Sedatives
Immunoglobulins
Steel
