Cephalic Tetanus: case report of a rare complication of orbito-ocular injury in a Nigerian

  • OA Ogun Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan Nigeria
  • AO Ashaye Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan Nigeria
  • SO Ola Department of Medicine, College of Medicine, University of Ibadan, Ibadan Nigeria
Keywords: cephalic tetanus, orbital injury, cranial nerves, anti-tetanus prophylaxis, occupational hazzard

Abstract

Objectives:

• To highlight the risk of cephalic tetanus resulting from penetrating orbital injury.

• To alert ophthalmologists to the importance of ensuring adequate anti-tetanus prophylaxis in all cases of ophthalmic and in particular orbital trauma most especially where foreign body retention is involved or is likely.

Methodology: A case of cephalic tetanus in a 24-year old Nigerian motor mechanic; presenting with torticollis, trismus, facial and neck muscle spasms and multiple cranial nerve palsies affecting the IIIrd, IVth, Vth and VIIth cranial nerves is reported. This followed a penetrating injury to the left orbit with a retained metallic foreign body. The patient’s anti-tetanus immunization status was not known prior to the injury. The patient developed symptoms of cephalic tetanus some days after receiving the anti-etanus serum intramuscularly. He was treated vigorously with anti-tetanus serum, intravenous diazepam and fluids, intravenous metronidazole and other parenteral broad- spectrum antibiotics. He was also actively immunized with tetanus toxoid injections.

Results: He made a slow but remarkable recovery after about five weeks (38 days) with minimal neurological deficit.

Keywords: cephalic tetanus, orbital injury, cranial nerves, anti-tetanus prophylaxis, occupational hazzard

Nigerian Journal of Ophthalmology Vol. 13 (1) 2005: 32-35
Published
2005-10-24
Section
Articles

Journal Identifiers


eISSN: 2468-8363
print ISSN: 0189-9171