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Opisthotonos

Written by Amanda Delgago
Medically Reviewed by George Krucik, MD

What Is Opisthotonos?

Opisthotonos is a type of abnormal posturing caused by strong muscle spasms. It mainly affects babies and young children because their nervous systems have not fully developed. Some of the conditions associated with it are serious, so prompt medical care is often needed.

The muscle spasms will cause your child’s back to be severely arched, and your child’s heels and head will be bent back to an extreme degree. Your child’s hands and arms will move around in a stiff manner. The spasms can come on suddenly and occur repeatedly. They can also occur in adults, but this is much less common.

Underlying Causes

The following underlying causes can lead to these spasms:

Brain Conditions

Meningitis is the most common reason for these spasms. It occurs when the meninges (the membranes around the brain and spinal cord) become inflamed due to viruses or bacteria. These spasms are the body’s way of trying to relieve the pain caused by irritation in the meninges. It helps by keeping your child’s spine still.

Arnold-Chiari syndrome is a structural defect that occurs when the back part of your child’s brain grows down through the bottom of the skull. It usually causes severe spasms in children who also have excess fluid in the brain (hydrocephalus).

Subarachnoid hemorrhage happens when your child has bleeding in the area between the brain and the tissues around it. It can be caused by injuries, a widening of the blood vessels called an aneurysm, or bleeding disorders.

Tetanus

Your child can get this disease when the bacteria that are found in soil and animal droppings enter the body through a wound. However, vaccines have made it rare. Tetanus is treatable but can be fatal in people who have not been vaccinated.

Adrenergic Bronchodilator Overdose

Bronchodilators are inhalers used to treat asthma and chronic cases of bronchitis. This condition happens when too much medication is inhaled.

Other possible causes include brain tumors, head injuries, and seizures. In rare cases, these spasms can occur in babies who go through alcohol withdrawal if an alcoholic mother drank excessively while pregnant.

When to See the Doctor

You should call your child’s doctor if your child has spasms along with any other symptoms associated with the following conditions. The following are considered medical emergencies:

meningitis

• high fever

• nausea

• confusion

• persistent crying

• extreme sleepiness

Call the National Poison Control Center at 1-800-222-1222 if you suspect that your child might have inhaled too much asthma or chronic bronchitis medication. Bring your child to the emergency room if you see signs of an overdose, which can include:

  • trouble breathing
  • rapid breathing
  • blue lips and fingernails
  • nausea
  • vomiting
  • convulsions
  • rapid heartbeat
  • dilated pupils

Subarachnoid hemorrhages usually cause extremely painful headaches near the back of the head. Other symptoms include:

  • sensitivity to light
  • decreased alertness
  • vision problems
  • stiff neck
  • nausea
  • muscle soreness in the neck and shoulders

Tetanus infections commonly cause stiff jaw, neck, and abdominal muscles, and difficulty swallowing. Other symptoms include fever, sweating, and fast heart rate.

Treating Opisthotonos

The methods of treatment depend upon the underlying condition.

Your child’s doctor will treat bacterial meningitis with antibiotics. The viral form usually treated with over-the-counter pain relievers, bed rest, and fluids.

Arnold-Chiari syndrome is treated with surgery to correct the malformation. If your child also has excess fluid in the brain, a shunt can be used to drain the liquid and relieve pressure.

If your child has bleeding in the brain, surgery can fix the cause of it, relieve pressure on the brain, and prevent permanent brain damage.

Tetanus cannot be cured, but medications can relieve symptoms, and cleaning the wound can stop the infection from spreading. Treatment with antibiotics to kill the bacteria is coupled with tetanus anti-toxin to reduce the impact of the infection. Your child might need supportive care, such as a ventilator to help with breathing.

A bronchodilator overdose is treated with fluids given intravenously.

Preventing Opisthotonos

You can reduce your child’s risk of having opisthotonos by taking steps to prevent the underlying conditions that cause it.

You can decrease your child’s risk of having meningitis through frequent hand washing and staying away from others who have this illness. Vaccines can protect your child from some forms of bacterial meningitis.

Treating aneurysms promptly can reduce your child’s risk of subarachnoid hemorrhage.

Vaccines help prevent tetanus infections. Make sure your child follows the recommended vaccine and booster schedule for full immunization.

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