Article Text

Download PDFPDF
Case report
Making an objective diagnosis of tetanus—utility of a simple neurophysiological test
  1. Hina Imtiaz,
  2. Haris Hakeem,
  3. Anusha Alam and
  4. Dureshahwar Kanwar
  1. Section of Neurology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
  1. Correspondence to Dr Haris Hakeem; haris.hakeem{at}


Tetanus remains a significant cause of mortality especially in the developing world. Early diagnosis and institution of treatment is critical to prevent fatal complications. The diagnosis is made on clinical grounds, which may sometimes be difficult, especially in case of localised tetanus. Being able to diagnose tetanus objectively is invaluable in such cases. In this regard, masseter inhibitory reflex (MIR) is a simple neurophysiological test that can be performed at the bedside. Herein, we report a case of craniocervical tetanus that was objectively diagnosed using MIR and adequately treated.

  • infectious diseases
  • infection (neurology)
  • clinical neurophysiology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors DK, HH and HI were part of the team that diagnosed and treated the patient. HH and HI put forward the idea of writing the case report which was approved by DK. HI and AA wrote the initial draft which was supervised, critiqued and edited by DK and HH. All authors reviewed and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.