What should you know about cephalic tetanus symptoms?

Tetanus is caused by a toxin produced by bacteria entering damaged skin, often through a wound. The cephalic form involves cranial nerves and may follow a head or face injury, an ear problem, or another entry point. Possible features include facial weakness, difficulty opening the mouth, jaw stiffness, trouble swallowing, changes in speech, and abnormal muscle tightening. Symptoms can progress and may occur with more widespread spasms.

A symptom alone cannot confirm tetanus. Clinicians consider the examination, the wound history, vaccination history, and the pattern and timing of symptoms. Tetanus is a medical emergency because muscle spasms can interfere with swallowing and breathing.

Do not wait for symptoms to settle if cephalic tetanus is possible. Go to an emergency department or call emergency services, especially after a contaminated, deep, crush, burn, or puncture wound. Do not put objects into a stiff mouth. Tell the clinical team when the injury happened, how it was cleaned, and when you last received a tetanus vaccine. Treatment may include wound care, medicines that neutralise toxin, antibiotics, and monitoring of breathing and muscle activity.

Seek emergency care immediately for facial weakness with jaw stiffness, repeated spasms, choking, difficulty swallowing, noisy breathing, or rapidly worsening symptoms. A wound can require assessment even when it looks small, particularly if it contains soil or a foreign material. Do not use the absence of fever or a visible wound to rule out tetanus.

Ask whether your wound needs cleaning or further treatment, whether your vaccination record is up to date, and what monitoring is required. Ask which changes in swallowing, facial movement, jaw movement, or breathing should be reported immediately.