Tetanus classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]


Tetanus may be classified according to different presentations into neonatal, cephalic, generalized or local.[1]


Tetanus may be classified according to its patterns of presentation as follows:[1][2][3][4]


Generalized Tetanus

Generalized tetanus is characterized by generalized muscle spasm of the body. Neck stiffness, abdominal stiffness, trismus and stiffness of other muscle groups may be observed. Flexion of the upper limbs, extension of the lower limbs, arcing of the back and fist clenching may be seen during a generalized tetanic spasm.

Local Tetanus

Local tetanus refers to the spasm of the muscles limited to one region or limb of the body. The spasm is usually seen around the site of injury.

Cephalic Tetanus

Cephalic tetanus presents with the exclusive involvement of the cranial nerves. Facial nerve is the most commonly affected nerve in cephalic tetanus. Other cranial nerves involved in cephalic tetanus may include cranial nerves III, IV, VI, and XII.

Neonatal Tetanus

Neonatal tetanus, as specified by the name, occurs in neonates. Difficulty in feeding due to the inability to open the mouth, an increase in the tone of the muscles , clenching of fists and dorsiflexion of the feet may be seen.


  1. 1.0 1.1 Angurana SK, Jayashree M, Bansal A, Singhi S, Nallasamy K (2017). "Post-neonatal Tetanus in a PICU of a Developing Economy: Intensive Care Needs, Outcome and Predictors of Mortality". J Trop Pediatr. doi:10.1093/tropej/fmx020. PMID 28460120.
  2. Gulamhussein MA, Li Y, Guha A (2016). "Localized Tetanus in an Adult Patient: Case Report". J Orthop Case Rep. 6 (4): 100–102. doi:10.13107/jocr.2250-0685.592. PMC 5288609. PMID 28164065.
  3. Kotani Y, Kubo K, Otsu S, Tsujimoto T (2017). "Cephalic tetanus as a differential diagnosis of facial nerve palsy". BMJ Case Rep. 2017. doi:10.1136/bcr-2016-216440. PMID 28108438.
  4. Felter RA, Zinns LE (2015). "Cephalic Tetanus in an Immunized Teenager: An Unusual Case Report". Pediatr Emerg Care. 31 (7): 511–3. doi:10.1097/PEC.0000000000000360. PMID 25853723.

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