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Opisthotonos
Opisthotonos is a condition in which a person holds their body in an abnormal position. The person is usually rigid and arches their back, with their head thrown backward. If a person with opisthotonos lies on their back, only the back of their head and heels touch the surface they are on.
Considerations
Opisthotonos is much more common in infants and children than in adults. It is also more extreme in infants and children because of their less mature nervous systems.
Causes
Opisthotonos may occur in infants with meningitis. It may also occur as a sign of reduced brain function or injury to the nervous system.
Other causes may include:
- A problem with the structure of the brain called Arnold-Chiari syndrome
-
Brain tumor
Brain tumor
A brain tumor is a group (mass) of abnormal cells that start in the brain. This article focuses on primary brain tumors in children.
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Gaucher disease
, which causes a buildup of fatty tissue in certain organs
Gaucher disease
Gaucher disease is a rare genetic disorder in which a person lacks an enzyme called glucocerebrosidase (GBA).
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Growth hormone deficiency
(occasionally)
Growth hormone deficiency
Growth hormone deficiency means the pituitary gland does not make enough growth hormone.
Read Article Now Book Mark Article - Forms of chemical poisoning called glutaric aciduria and organic acidemias
-
Krabbe Disease
, which destroys the coating of nerves in the central nervous system
Krabbe Disease
Krabbe disease is a rare genetic disorder of the nervous system. It is a type of brain disease called leukodystrophy.
Read Article Now Book Mark Article - Seizures
-
Severe
electrolyte
imbalance
Electrolyte
Electrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...
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Severe
head injury
Head injury
A head injury is any trauma to the scalp, skull, or brain. The injury may be only a minor bump on the skull or a serious brain injury. Head injury c...
Read Article Now Book Mark Article - Stiff-person syndrome (a condition that makes a person rigid and have spasms)
- Bleeding in the brain
-
Tetanus
Tetanus
Tetanus is an infection of the nervous system with a type of bacteria that is potentially deadly, called Clostridium tetani (C tetani).
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Some antipsychotic medicines can cause a side effect called acute dystonic reaction. Opisthotonos may be part of this reaction.
Acute
Acute means sudden or severe. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
In rare cases, infants born to women who drink large amounts of alcohol during pregnancy may have opisthotonus due to alcohol withdrawal.
Home Care
A person who develops opisthotonos will need to be cared for in a hospital.
When to Contact a Medical Professional
Go to the emergency room or call your local emergency number (such as 911) if symptoms of opisthotonos occur. Typically, opisthotonos is a symptom of other conditions that are serious enough for a person to seek medical attention.
What to Expect at Your Office Visit
This condition will be evaluated in a hospital, and emergency measures may be taken.
Your health care provider will take a medical history and perform a physical examination to look for the cause of opisthotonos
Physical examination
During a physical examination, a health care provider studies your body to determine if you do or do not have a physical problem. A physical examinat...
Medical history questions may include:
- When did this behavior start?
- Is it always the same type of posturing?
- What other symptoms came before or with the abnormal posturing (such as fever, stiff neck, or headache)?
- Is there any recent history of illness?
The physical examination will include a complete checkup of the nervous system.
Tests may include:
- Blood and urine tests
-
Cerebrospinal fluid (CSF) culture
and cell counts
Cerebrospinal fluid (CSF) culture
A cerebrospinal fluid (CSF) culture is a laboratory test to look for bacteria, fungi, and viruses in the fluid that moves in the space around the spi...
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CT scan of the head
CT scan of the head
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
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Electrolyte
analysis
Electrolyte
Electrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...
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Lumbar puncture
(spinal tap)
Lumbar puncture
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
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MRI of the brain
MRI of the brain
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
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References
Chiriboga CA. HIV, fetal alcohol and drug effects, and the battered child. In: Rowland LP, Pedley TA, eds. Merritt's Neurology . 12th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009.
Layzer RB, Rowland LP. Muscle cramps and stiffness. Merritt's Neurology . 12th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009:chap 145.
Patterson MC, Johnson WG. Lysosomal and other storage diseases. In: Rowland LP, Pedley TA, eds. Merritt's Neurology . 12th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009.
Scher MS, Diagnosis and treatment of neonatal seizures. In: Perlman JM, ed. Neurology: Neonatal Questions and Controversies . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 8.
Thwaites LC, Yen LM. Tetanus, In: Farrar J, Hotez PJ, Junghanss T, Kang G, Lalloo D, White NJ, eds. Manson's Tropical Diseases . 23rd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 32.
Review Date: 6/1/2015
Reviewed By: Daniel Kantor, MD, Kantor Neurology, Coconut Creek, FL and Immediate Past President of the Florida Society of Neurology (FSN). Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
