How Do You Treat Opisthotonos?

Have you ever had an episode where you feel your muscles seem difficult or painful to be moved? This may be muscle spasm which is often considered normal after a long hours of activities or a workout. This muscle spasm that is often seen as muscle twitches can be avoided with good stretch before and after the physical activities. However, there are muscle spasms that may be indicative of a serious issue such as opisthotonos. In this DoctorOnCall’s article, we will learn more about opisthotonus.

Opisthotonus is defined as dramatic abnormal posture caused by strong muscle spasms. The muscle involved is the muscle in the neck, back and legs. The spasm and contraction of these muscles causes the body to bend backwards into a rigid arch with the head pointing towards the feet or in other words, backward arching from neck to heel. Most cases of opisthotonus cause the trunk to be elevated off the ground by a few inches. Opisthotonus can occur suddenly or sustained. This condition may be repetitive.

There are many causes or reasons that could cause opisthotonus such as meningitis, chemical poisoning such as strychnine, overdose on anaesthetic drugs, brain damage such as cerebral palsy and genetic conditions such as Gaucher disease and Dandy-Walker malformation. Despite this, the most common cause is tetanus and typical opisthotonus can be found in tetanus.

Opisthotonus is suspected when a person shows abnormal posture of the arching of the back and extension of the limbs. Body of those with opisthotonic posture will form a stiff “C” shape. Symptoms associated with opisthotonus are the clue for the underlying condition or disease. These symptoms could be fever, increased heart rate, fluctuating blood pressure, breathing difficulty, vomiting, seizures, pain, discomfort, fatigue and altered consciousness. It can be difficult to see opisthotonus in children as they can be restless, crying or presented with other muscle contraction at times which can mask the opisthotonus. Despite this, children with uncontrollable and persistent crying with muscle spasms should be considered as signs of possible opisthotonus.

Due to the fact that there are many causes that could lead to opisthotonus, it is best to bring the person with such a condition immediately to a health professional. This will help doctors to identify the cause and treat the underlying conditions that will help to relieve the opisthotonus. Beside doctors taking medical history and performing physical examination, they often request for tests such as blood test, urine test, imaging test and spinal tap. It is important for those who show signs of opisthotonus to get medical attention immediately as delay in diagnosis and receiving treatment may actually be life-threatening. Furthermore, early diagnosis can help prevent complications that can be permanent or irreversible.

Treatment for opisthotonus will depend on the underlying health conditions that cause the issue. For example, opisthotonus caused by infection such as rabies may be given immunoglobulins to help fight the infection. Deep brain stimulation may be provided in opisthotonus associated with Parkinson’s disease. Enzyme replacement therapy is prescribed for Gaucher disease to manage the buildup lipid. People with opisthotonus not only need to be treated for the underlying cause, but also require supportive care to help patients maintain their normal body functions. This includes monitoring fluid and electrolyte, pain relief, medication such as benzodiazepine to relieve muscle spasms and to ensure patients receive adequate nutrition.

Tetanus is an infection caused by bacteria known as Clostridium tetani. These bacteria are able to affect the body from the toxin it produces. The toxin will cause painful muscle contractions. The most common ways of tetanus being able to enter the human body is via broken skin, commonly injuries. This could be punctured wounds such as from nail or needle, burns and crush injuries. The likelihood of developing tetanus is high when the wound is contaminated with dirt, saliva or faeces. Tetanus is considered as an emergency which requires the patient to get emergency care immediately after suspected tetanus such as injury or symptoms of spasms of the jaw muscles. Since tetanus is often seen with the typical opisthotonus, it is worth taking time and knowing what to do to avoid tetanus.  Getting a tetanus vaccine is the best way to avoid it.

It can be concluded that opisthotonus is the abnormal posture caused by the muscle spasm in the neck, trunk and lower extremities. Opisthotonus itself is not a disease but more of a symptom or signs of underlying health conditions. Opisthotonus is considered as a serious medical problem and when a person starts to show symptoms associated, patients need to get immediate medical care. Treatment to ease opisthotonus will depend on the cause and finding the cause will usually require doctors to run tests and examinations. Opisthotonus can be difficult to be seen in children but uncontrollable and persistent crying on top of muscle spasms should be suspicious of opisthotonus.