Wry face

Introduction Tetanus is a neurological syndrome caused by Clostridium tetanus toxin. Patients with local or systemic muscles or tonic spasm, often affected by facial and neck muscles, closed jaws and "smiley face". This kind of laughter is not caused by the patient's heart, but is a destructive pathological manifestation. The result is that the sputum toxin secreted by tetanus bacillus first invades the facial muscles and causes tension contraction. Laughter is accompanied by symptoms such as tightness of the jaws, rigidity of the limbs and reversal of the horns.

Cause

The disease is caused by a broken skin and a feeling of wind and poison. After the trauma, the skin breaks the blood loss, and the external body loses its solidity. In the case of the body's resistance decline, the evil of wind poison invades the human body from the wound, and the disease occurs from the outside. The wind is a yang, the number of good deeds changes, the liver passes through the meridians and blood vessels, the external wind induces the internal wind, the liver wind moves, the tendons are dying and the jaws are closed, the horns are reversed, and the limbs are convulsions.

an examination

Related inspection

Blood routine cranial nerve examination

1. The patient has a history of open injury infection, or the umbilical cord disinfection of the newborn is not strict, postpartum infection, history of surgery.

2. The performance of the prodromal period is weak, headache, hard tongue, inconvenient swallowing and unsatisfactory rotation of the head and neck.

3. Typical manifestations of muscle persistent tonic contraction and paroxysmal convulsions, initial chewing inconvenience, masticatory muscle tension, painful rigidity, difficulty opening mouth, bitter smile face, difficulty swallowing, stiff neck, angulation, difficulty breathing, nervous And even suffocate.

4. Slight stimuli (glare, wind, sound, vibration, etc.) can induce seizures.

5. Local type tetanus, muscle tonic contraction is limited to the vicinity of the wound or injured limb, the general incubation period is longer, the symptoms are lighter, and the prognosis is better.

Differential diagnosis

Need to be identified with the following symptoms:

A sly face: the facial expression of the face: the typical face and expression of the thoughts and emotions on the face or posture, with certain diagnostic value. The face of smirk is manifested as the closed jaw of the episode, the facial muscle spasm, and a bitter smile.

Mandatory crying and laughing: refers to the sudden burst of the outside without temptation, can not control or have a compulsory cry, the patient's facial expression is stupid, strange, lack of inner experience.

Weird smile: laughter is the natural expression of people's joy, some smiles are pathological, and are special symptoms of disease. The ridiculous laugh is a kind of squinting and a strange smile on the face of a patient with facial paralysis and paralysis.

This kind of laughter is not caused by the patient's heart, but is a destructive pathological manifestation. The result is that the sputum toxin secreted by tetanus bacillus first invades the facial muscles and causes tension contraction. Laughter is accompanied by symptoms such as tightness of the jaws, rigidity of the limbs and reversal of the horns.

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