Imagine, someone you know, perhaps a family member, suddenly loses consciousness, and their body, especially their back and neck, arch back and forth like a bow. If you were lying on your back in bed, their back would arch up and form a bridge. Anyone who sees this would be very scared, wouldn't they? It's a really scary sight. In medicine, we call this 'opisthotonos'. This is not just a muscle twitch, but could be a sign of a much deeper and more serious health problem.
What exactly is 'Opisthotonos'?
Simply put, opisthotonos is an involuntary, very strong contraction of the muscles of the neck and back. This is not something the person can control . It is like a reflex action. At this point, the patient is usually unconscious or in a coma.
When the body bends backwards like this, it gives a great shock to those who see it.
- If you are lying on your back: Lift your chest and stomach up off the floor or bed.
- If you are lying on your side: Your body will bend into a crescent moon-like shape.
The important thing is, this is not normal. Opisthotonos is a strong sign that something very serious has happened to the brain or nervous system.
Why is this happening? What are the main reasons?
There is not one reason for this dangerous condition, but there can be many reasons. All of these reasons directly affect brain function. Let's see what the main categories of causes are.
| Category of causes | Examples |
|---|---|
| Infections | Severe infections that affect the brain. Examples: Tetanus, Meningitis, Encephalitis, Rabies. |
| Toxins, Poisons, and Drugs | Some anesthetics (e.g. Propofol - very rare), poisons such as strychnine, some older drugs used for mental illness, drugs such as PCP, and the sting of some venomous spiders or scorpions. |
| Brain Damage or Diseases | Conditions such as intracranial hemorrhage, cerebral hypoxia, severe head injuries, seizures, brain lesions, hydrocephalus, and Parkinson's disease. |
| Developmental or Metabolic Conditions | This condition can also be caused by some genetic and metabolic diseases. Examples: Cerebral Palsy, Kernicterus (brain damage caused by severe jaundice in newborns). |
What would you do if you saw this?
If you see someone with opisthotonos, it should be considered a medical emergency . Never attempt to treat the condition at home. The only thing to do is to get the patient to a hospital's Emergency Department (ETU) as soon as possible. Time is of the essence here.
What are the treatments for this?
It's important to understand this. Doctors don't treat the twisting of the body called opisthotonos. They treat the underlying cause of the condition.
For example, if the cause is tetanus, the treatment is for the tetanus. If the cause is a brain hemorrhage, the treatment is for that. Therefore, the treatment regimen can be completely different from patient to patient.
Since patients in this condition are usually unconscious, medical decisions are left to the family. In such a situation, only your doctor can best explain to you what treatment is best for your loved one. Ask him or her everything clearly.
What can we do to prevent this?
Many of the things that cause opisthotonos are unpredictable and beyond our control. However, there are some things we can try to prevent.
- Get vaccinated properly: Tetanus and RabiesThese are diseases that can be prevented by vaccination. If you are unsure about your vaccination details, especially if you have been bitten by an animal or have a deep wound, see a doctor immediately for advice.
- Protect your head: Wear a helmet when riding a bicycle or motorbike. Wear a seat belt when riding in a car. These safety measures can help reduce head injuries and the resulting brain damage.
- Stay away from drugs: Do not use any medication or drug (especially PCP) without a doctor's prescription. If you experience any unusual muscle spasms while taking a medication prescribed by a doctor, inform your doctor immediately.
- Be careful of poisonous animals: Wear protective gear such as gloves when working in the garden, collecting firewood, or cleaning up areas where spiders and scorpions may be present. If you are bitten by a poisonous animal and develop unusual symptoms, go to a hospital immediately. If you suspect that you have ingested a poison, you can immediately call the National Poison Information Center at the Colombo National Hospital for advice.
Take-Home Message
- Opisthotonos is an involuntary muscle contraction that causes the body to bend backward like a bow. This is a very rare condition.
- This is not normal and can be a symptom of a very serious condition affecting the brain or nervous system.
- If you see this symptom in someone, consider it a medical emergency and immediately take the patient to a hospital's Emergency Treatment Unit (ETU).
- Treatment is not for the bending of the body, but for the underlying disease that caused it . Therefore, treatment varies from patient to patient.
- Providing prompt and accurate medical treatment goes a long way in saving the patient's life and minimizing damage to the brain.
👩🏽⚕️ Additional questions (FAQs)
💬 What is arm pain? Is this a common problem?
It is normal to feel sore muscles in your arms after lifting something heavy. But 'Arm Pain' in medical science refers to an unbearable burning/numbness or dull/sharp shooting pain that occurs in your arms (from the neck to the shoulders, elbows and fingers) for some reason. This can be a sign of an injury to the muscles in your arms, as well as a warning sign of a 'life-threatening emergency' inside the body (heart/brain)!
💬 What are the main reasons why a well-trained arm suddenly hurts like this (Arm Pain)?
The main causes of arm pain are: 1) Cervical Radiculopathy - In this, the arm feels numb as if an electric current is being sent down from the neck down the arm. 2) Carpal Tunnel Syndrome - The nerves near the wrist are compressed and the fingers become numb. 3) A muscle/cartilage tear. But the most dangerous reason is that when the heart does not have enough blood/has a heart attack (Angina / Myocardial Infarction), the pain spreads down the 'left arm'!
💬 When you hurt your hand, what are the 'fatal/emergency situations' in which you should go to the hospital immediately without applying balm/massage at home?
For a normal injury, you can apply ice/hot water and rest. But the biggest danger! 1) If the pain in the arm (especially the left arm) comes with 'chest pain & shortness of breath', it is definitely a heart attack! 2) If the arm suddenly becomes 'completely numb/heavy' and the face falls to one side without any pain (Sudden unilateral weakness), it is a blood vessel in the brain that has burst/blocked and is causing a stroke, you need to be hospitalized immediately!
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