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The stapedial reflex in cephalic tetanus

Published online by Cambridge University Press:  29 June 2007

Chris de Souza ,
Dilip Karnad ,
Rosemarie de Souza ,
A. Raje ,
K. Mansukhani  and
G. H. Tilve
Chris de Souza*
Affiliation:
Departments of Medicine, Audiology and Neurology, KEM Hospital, Parel, Bombay 400 012, India.
Dilip Karnad
Affiliation:
Departments of Medicine, Audiology and Neurology, KEM Hospital, Parel, Bombay 400 012, India.
Rosemarie de Souza
Affiliation:
Departments of Medicine, Audiology and Neurology, KEM Hospital, Parel, Bombay 400 012, India.
A. Raje
Affiliation:
Departments of Medicine, Audiology and Neurology, KEM Hospital, Parel, Bombay 400 012, India.
K. Mansukhani
Affiliation:
Departments of Medicine, Audiology and Neurology, KEM Hospital, Parel, Bombay 400 012, India.
G. H. Tilve
Affiliation:
Departments of Medicine, Audiology and Neurology, KEM Hospital, Parel, Bombay 400 012, India.
*
Chris de Souza, St Peter's Colony, 16 Xavier House, Manuel Gonsalves Road, Bandra, Bombay 400 050, India.
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Abstract

Three patients are presented with cephalic tetanus following injuries to the face. Two were adults and one a child. All three had bilateral VIIth cranial nerve involvement and one patient also presented with involvement of the IIIrd, IVth and VIth cranial nerves. The patients initially an ipsilateral VIIth cranial nerve weakness which later in the course of the illness developed into hyperactivity of the VIIth cranial nerve. The contralateral VIIth cranial nerve demonstrated a similar pattern. The stapedial reflex was tested serially. The stapedius muscle activity preceded that of the muscles of the face thus serving as an indicator of improvement or impending deterioration. Deflections measuring more than 1 cm, on stapedial reflex threshold testing, were indicative of stapedial reflex spasm. In the stapedial reflex decay test, both ill-sustained (intermittent) and sustained spasms of the stapedius muscle were seen.

Keywords

TetanusFacial paralysisAcoustic impedance testsStapedius muscle
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 9 , September 1994 , pp. 736 - 742
Copyright
Copyright © JLO (1984) Limited 1994

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