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Case Report: A Case Report and Literature Review on a Cephalic Tetanus with Positive Myelin Oligodendrocyte Glycoprotein Antibodies Patient

Yuqi Lin, Miaojuan Yang, Xuejun Fu*

Abstract


Tetanus is a fatal disease caused by Clostridium tetanus, the main clinical symptoms are muscle spasm and autonomic nervous system dysfunction. The diagnosis of tetanus is completely based on the medical history and clinical symptoms, its easy to misdiagnosed and delayed diagnosis. This paper reports a case of cephalic tetanus with positive myelin oligodendrocyte glycoprotein antibody (MOG). The patient
began with unilateral ptosis, diplopia, trismus, positive Fatigue Test, positive Neostoxmine Test, and was easily misdiagnosed as Myasthenia
Gravis. Subsequently, multiple groups of cranial nerve damage occurred, so the diagnosis of acute Guillain-Barrsyndrome cannot be ruled
out. Finally, through further analysis of clinical symptoms, therapeutic effect, and in-depth collection of medical history, the patient was diagnosed with cephalic tetanus. After systemic anti-tetanus treatment, the patient has recovered. This case is expected to enhance the diagnostic
and therapeutic capabilities of clinical physicians for cephalic tetanus, to avoid delaying the best time for treatment.

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References


[1] Lam Minh Yen, C Louise Thwaites. Tetanus [J], Lancet, 2019 Apr 20; 393(10181): 1657-1668. DOI: 10.1016/S0140-6736(18)33131-3.

[2] Finkelstein P, Teisch L, Allen C J, et al. Tetanus: a potential public health threat in times of disaster[J]. Prehosp Disaster Med, 2017, 3 (3):

339-342. DOI: 10.1017 / S1049023X17000012.

[3] Aram Megighian, Marco Pirazzini, et al. Tetanus and tetanus neurotoxin: From peripheral uptake to central nervous tissue targets[J].

Neurochem, 2021 Sep; 158(6): 1244-1253. DOI: 10.1111/jnc.15330.

[4] Cara Callison, Hao Nguyen. Tetanus Prophylaxis[M]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.

[5] Min Dong, Geoffrey Masuyer, et al. Botulinum and Tetanus Neurotoxins[J]. Annu Rev Biochem. 2019 Jun 20:88:811-837. DOI: 10.1146

/ annurev - biochem - 013118-111654.

[6] Pellizzari R, Rossetto O, et al. Tetanus and botulinum neurotoxins: mechanism of action and therapeutic uses[J]. Philos Trans R Soc

Lond B Biol Sci. 1999 Feb 28; 354(1381):259-68. DOI: 10.1098/rstb.1999.0377.

[7] Rgonul O, Egeli d, et al. An unexpected tetanus case[J]. Lancet Infect Dis. 2016 Jun; 16(6):746-752. DOI: 10.1016/S1473-3099-

(16)00075-X.

[8] T M Cook, R T Protheroe, et al. Tetanus: a review of the literature[J]. British journal of anaesthesia. 87(3):477-87(2001).

[9] Mondkar S A, Tullu M S, et al. Clinical profile and outcome of pediatric tetanus at a tertiary care center[J]. Pediatr Intensive Care, 2020,

10(4): 256-263. DOI: 10.1055/s-0040-1715854.

[10] Rhinesmith E, Fu L D. Tetanus disease, treatment, management[J]. Pediatr Rev, 2018, 39(8): 430-432. DOI: 10.1542 / pir. 2017-0238.

[11] Expert Group for the preparation and approval of norms for Diagnosis and Treatment of non-neonatal tetanus (2019 edition).

Standard for Diagnosis and treatment of non-neonatal tetanus (2019 edition) [J]. Chinese Journal of Emergency Medicine, 2019,

28(12):14701475. (in Chinese) DOI: 10.3760/ cma.j.issn.1671-0282.2019.12.003.

[12] Brenda Banwell, Jeffrey L Bennett, et al. Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International

MOGAD Panel proposed criteria[J]. Lancet Neurol. 2023 Mar; 22(3):268-282.: 10.1016/S1474-4422(22)00431-8.

[13] Jonathan D Krett, et al. "Lupus Myelitis" Revisited: A Retrospective Single-Center Study of Myelitis Associated With Rheumatologic

Disease[J]. Neurol Neuroimmunol Neuroinflamm. 2025 Jan; 12 (1): e200329. DOI: 10.1212 / NXI. 0000000000200329.

[14] Talita Siara Aimeida Baptista, et al. Autoantibodies against myelin sheath and S100? are associated with cognitive dysfunction in patients with rheumatoid arthritis[J]. Clin Rheumatol. 2017 Sep; 36(9):1959-1968. DOI: 10.1007/s10067-017-3724-4.

[15] Jyh Yung Hor, et al. Epidemiology of myelin oligodendrocyte glycoprotein antibody-associated disease: a review of prevalence and incidence worldwide[J]. Front Neurol. 2023 Sep 15; 14. 1260358. DOI: 10.3389 / fneur. 2023.1260358




DOI: http://dx.doi.org/10.70711/pmr.v2i4.6118

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