Opisthotonos: Signs, Symptoms, Causes, and Treatment

Photo by: Bigstockphoto
Photo by: Bigstockphoto

Opisthotonos is a type of severe form of hyperextension, in which the patient’s head and back enters a complete arching or bridging position. This condition is caused by strong muscle spasms. Usually, opisthotonos occurs when the nervous system is not fully developed. As such, this condition is common among babies and toddlers. However, there are cases wherein opisthotonos occurs in adult patients but this is a very rare case.

Signs and Symptoms of Opisthotonos

Opisthotonos is characterized by severe arching of the back, with the heels and head bent at an extreme angle. The arms and hands move in a stiff manner due to muscle spasms. The intensity and frequency of the muscle spasms will vary.

Some of the symptoms of opisthotonos can cause serious health problems that’s why it’s best to take the patient to the hospital if he or she exhibited the following symptoms:

  • High fever
  • Confusion
  • Persistent crying
  • Meningitis
  • Extreme sleepiness
  • Nausea
  • Trouble breathing
  • Convulsions
  • Blue lips and fingernails
  • Rapid breathing

Other symptoms, such as sensitivity to light, vision problems, muscle soreness and decreased alertness could be signs of subarachnoid hemorrhages. Subarachnoid hemorrhages are complications following an opisthotonos episode. For opisthotonos triggered by tetanus infection, the symptoms include stiff neck and jaw, abdominal pains and difficulty in swallowing.

Causes of Opisthotonos

Serious health problems are often the cause of opisthotonos. Below are the possible causes of this condition:

Brain Infection

Meningitis can cause severe muscle spasms. This condition occurs when the brain membranes and the spinal cord become infected with bacteria or viruses. The spasms are the body’s way of eliminating the pathogens that affect the meninges.

Arnold-Chiari syndrome is a condition that affects the back of the brain. It’s characterized by fluids pooling inside the brain. This condition is common among children and usually causes severe muscle spasms as well.

Subarachnoid hemorrhage is another possible cause of opisthotonos. This is caused by bleeding between the brain and the tissues from an injury such as an aneurysm, or bleeding disorders.


Tetanus is caused by a bacteria that thrives in animal feces and the soil. The bacteria enter the body through a wound. Although treatable, tetanus can be fatal among people who are not vaccinated.

Adrenergic Bronchodilator Overdose

An overdose of asthma inhalers and bronchitis medications can cause opisthotonos too. When the patient inhales too much medication, the muscles start contracting violently.

Opisthotonos Treatments

The treatment will depend largely on the underlying cause of the condition. For opisthotonos triggered by brain disorders, your doctor will prescribe antibiotics or pain relievers to keep the swelling down. For opisthotonos triggered by Arnold-Chiari syndrome and hydrocephalus, corrective surgery is required to ease severe muscle spasms.

For those afflicted with brain hemorrhage, the blood will be drained to reduce the pressure in the brain. As for those suffering from tetanus, there are medications that can relieve the symptoms and prevent bacteria from spreading. Finally, for opisthotonos triggered by bronchodilator overdose, the patient will be given lots of fluids to dull the medication and flush it from the system.

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