classification of tetanus

Last edited 05/2022 and last reviewed 09/2023

There are four different forms of tetanus:

  • localised
    • rare and relatively milder form of disease
    • spasm and rigidity are restricted to the site of injury
    • in some, may precede generalised tetanus
  • cephalic
    • occurs secondary to a middle ear infection or from a injury to the head and neck
    • cranial nerve palsies  (especially the seventh nerve) is characteristic
    • may develop in to a generalised disease
    • prognosis is poor (1)
  • generalized
    • most common type and is responsible for around 80% of patients
    • there is haematogenous spread of the toxin
    • head and neck muscles are affected first with progressive distal spread of spasm and rigidity throughout the body
  • neonatal
    • is responsible for over 50% of deaths associated with tetanus
    • caused by poor umbilical hygiene and is entirely preventable by maternal vaccination
    • symptoms like failure to thrive, poor sucking, grimacing and irritability is seen at first quickly followed by intense rigidity and spasms and  is usually seen from 4 to 14 days after birth (average around 7 days) (2)
    • is completely eliminated from the UK (1)

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