Diagnostic and therapeutic clues in the study of tetanus.

Abstract

DESPITE the infrequency of tetanus in clinical practice, the disease remains a major problem of therapy. Treatment in the past has consisted of the continued administration of sedative drugs. As a result, complications, such as hypoxia, pneumonia, and exhaustion, were difficult to prevent. Severe seizures usually cannot be arrested by sedation alone. Simultaneous electroencephalographic and electromyographic studies can be used to differentiate tetanus from other conditions. Seizures of tetanus do not originate from the cortex, and hence produce no change in the electroencephalogram. If, at the same time, recordings are made from the involved muscles, prolonged bursts of 30 to 60 cps discharges can be seen whether the spasms be spontaneous or induced. This combination of unaltered brain waves and the typical myographic response during a convulsion would seem to point to the diagnosis of tetanus. A therapeutic clue is offered by the effect of curarepreparations on the electroencephalogram and