Diagnosis and Differential Diagnosis of Tetanus

DIAGNOSIS
Diagnosis is based on clinical findings and a history of immunization:
1. A history of the contaminated wound, but 20% can be no history of injury.
2. History is not immunized or incomplete immunization
3. Trismus, dysphagia, rhisus sardonicus, stiffness in the neck, back, and abdominal muscles (opisthotonos), pain and anxiety.
4. In the early neonatal tetanus complaint form can not suck
5. Episodic generalized seizures triggered by minimal stimuli and spontaneous where consciousness remains good.

Clinical Manifestations of Tetanus

       Clinical manifestations of tetanus varies from local muscle rigidity, trismus up strong spasms. Period until the onset of the initial symptoms of tetanus spasms known onset of disease, which affects the prognostic.

Pathophysiology of Tetanus

       How can Clostridium Tetani attack human body? let's discuss pathophysiology of tetanus. Clostridium tetani enter the human body through wounds usually in the form of spores. This Disease appears when spores grow into vegetative forms that produce tetanospasmin on the state of low oxygen tension, tissue necrosis or oxygen reduction potential.

Tetanus

patient with tetanus

        Tetanus is a disease of the nervous system that is caused by tetanospasmin neurotoxin produced by Clostridium tetani, which is characterized by persistent tonic spasme accompanied by a clear and hard attack. Clostridium tetani enter the human body through wounds usually in the form of spores. Disease appears when the spores grow into vegetative forms produce tetanospasmin at low oxygen pressure conditions, or tissue necrosis oxygen reduction potential.

Medical Treatment and Therapy of Trigeminal Neuralgia

Carbamazepine

A. Medicamentosa
        The most effective drugs are carbamazepine (Tegretol ®) 3-4X 100-200 mg a day depending on tolerance. These drugs, an anticonvulsant, is effective in most cases but causes dizziness and nausea in some patients while other patients on skin rashes and leucopeniasehingga to be discontinued. After a few weeks or months of administration, the drug can be stopped but must be given again if the pain recurs.
      Drugs other than carbamazepine anticonvulsants can shorten the duration and severity of attacks. Medications such as this example phenitoin (300-400 mg / day), falproat acid (800-1200 mg / day), clonazepam (2-6 mg / day), and gabapentin (300-900 mg / day).

Diagnosis of Trigeminal Neuralgia

        Trigeminal neuralgia should be distinguished with facial pain other. Medical examination and history of the symptoms must be done together other tests to rule out serious problems. Diagnosis based on an accurate anamnesis, clinical examination and clinical trials for know the exact location of stimulus triggers and pain during the examination. criteria diagnosis of trigeminal neuralgia customized with advanced by Headache Society classification Internatianal 1988.

Symptoms and Signs of Trigeminal Neuralgia

Symptoms and Signs of Trigeminal neuralgia

Trigeminal neuralgia provide the following symptoms and signs

1. Neuropathic pain

Include severe paroxysmal pain , sharp, stabbing like, shot, electrocuted, hit by lightning, or burning a brief few seconds to a few minutes but less than two minutes, sudden and repetitive. Between attacks there is usually pain-free interval, or only mild dull taste.