What is opisthotonos?

Opisthotonosis 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. And 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.

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, or 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

This 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

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


Your child can get tetanus 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

This condition happens when you inhale too much medication. This can happen through misuse of a bronchodilator, the inhalers that treat asthma and chronic cases of bronchitis.

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 their mothers misused alcohol while pregnant.

Bronchodilator overdose

Call National Poison Control 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

Call your doctor immediately if you suspect your child may be having a subarachnoid hemorrhage. These 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


Call your doctor immediately if you think you or your child has a tetanus infection. Symptoms of a tetanus infection include:

  • stiff jaw
  • neck
  • abdominal muscles
  • difficulty swallowing
  • fever
  • sweating
  • fast heart rate

The methods of treatment depend upon the underlying condition.

Bacterial meningitis

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

Arnold-Chiari syndrome

Treatment depends on the severity of the malformation. Surgery is the most likely treatment to correct more symptomatic or advanced malformations.

If your child also has excess fluid in the brain, a shunt can be used to drain the liquid and relieve pressure.

Bleeding in the brain

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


Tetanus cannot be cured, but medications can relieve symptoms. Treatment usually involves:

  • cleaning the wound to keep the infection from spreading
  • antibiotics to kill the bacteria
  • tetanus anti-toxin injections to reduce the impact of the infection

Your child might need supportive care. For example, severe tetanus can affect the muscles a child needs to breathe. In that case, the doctor may use a ventilator to help with breathing.

Bronchodilator overdose

Your child will most likely receive intravenous fluids to counter the overdose.

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

Meningitis prevention

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 also protect your child from some forms of bacterial meningitis.

Subarachnoid hemorrhage prevention

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

Tetanus prevention

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