Clinical Tetanus: (Spinal) Disinhibition or Not?

  • Kohsi Takano


The most representative sign of tetanus is hyperactivity of the motor system. Most of the patients die, if not relaxed by adequate methods, due to an apnea, which is caused by “hyperactive” spasm of the respiratory muscles. Tetanus toxin may act not only on the motor system but also on the whole nervous system and therefore tetanus is a multisystemic disease including the disturbance of the autogenic nervous system. However, in this study only the effect of the toxin on the motor system will be discussed.


Motor System Spinal Segment Presynaptic Inhibition Tetanus Toxin Excitatory Transmission 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bergey, G.K., Bigalke, H., and Nelson, P.G., 1987, Differential effects of tetanus toxin on inhibitory and excitatory synaptic transmission in mammalian spinal cord neurons in culture: a presynaptic locus of action for tetanus toxin, J. Neurophysiol. 57: 121.PubMedGoogle Scholar
  2. Brooks, V.B., and Asanuma, H., 1962, Action of tetanus toxin in the cerebral cortex, Science 137: 674.PubMedCrossRefGoogle Scholar
  3. Brooks, V.B., Curtis, D.R., and Eccles, J.C., 1957, The action of tetanus toxin on the inhibition of motoneurones, J. Physiol. 135: 655.PubMedGoogle Scholar
  4. Curtis, D.R., and de Groat, W.C., 1968, Tetanus toxin and spinal inhibition, Brain Res. 10: 208.PubMedCrossRefGoogle Scholar
  5. Curtis, D.R., Felix, D., Game, C.J.A., and Mc Culloch, R.M., 1973, Tetanus toxin and the synaptic release of GABA, Brain Res. 51: 358.PubMedCrossRefGoogle Scholar
  6. Davies, J.R., Morgan, R.S., Wright, E.A., and Wright, G.P., 1954, Effect of local tetanus intoxication on the hind limb reflexes of the rabbit, Arch. Int. Physiol. 62: 248.PubMedGoogle Scholar
  7. Duchen, L.W., and Tonge, D.A., 1973, The effects of tetanus toxin on neuromuscular transmission and on the morphology of motor end-plate in slow and fast skeletal muscle of the mouse, J. Physiol. 228: 157.PubMedGoogle Scholar
  8. Fedinec, A.A., Toth, P., and Bizzini, B., 1985, Relation of spastic and flaccid paralysis to retrograde transport 125I-tetanus toxin and its 125I-Ibc fragment. Modulating effect of Flab] antibodies directed to specific areas on the toxin molecule, Boll. Ist. Serot. Milan 64: 35.Google Scholar
  9. Habermann, E., 1978, Tetanus, in: Infections of the nervous system, Part I, P.J. Vinken and G.W. Bruyn, eds., Handbook of clinical neurology, Vol. 33, North Holland Publ. Amsterdam, New York, Oxford, 491.Google Scholar
  10. Habermann, E., and Dimpfel, W., 1973, Distribution of 125I-tetanus toxin and 125I-tetanus toxoid in rats with generalized tetanus, as influenced by antitoxin, Naunyn-Schmiedeberg’s Arch. Pharmacol. 276: 361.CrossRefGoogle Scholar
  11. Huet de la Tour, E., Tardieu, C., Tabary, J.C., and Tabary, C., 1979, Decrease of muscle extensibility and reduction of sacomere number in soleus muscle following a local injection of tetanus toxin, J. Neurol. Sci. 40: 123.PubMedCrossRefGoogle Scholar
  12. Hahn, H., and Mielke, M., 1991, Infektion und Abwehr, in: Pathophysiologie des Menschen, K. Hierholzer und R.F. Schmidt, eds., VCH Publ. Weinheim, Wellington, New York, 39. 1.Google Scholar
  13. Huck, S., Kirchner, F., and Takano, K., 1981, Rhythmic activity in the cerebellum and spinal cord of rabbits receiving tetanus toxin intravenously, Naunyn-Schmiedeberg’s Arch. Pharmacol. 317: 51.CrossRefGoogle Scholar
  14. Kano, M., and Ishikawa, K., 1972, Effect of tetanus toxin on the inhibitory neuromuscular junction, Exp. Neurol. 37: 550.PubMedCrossRefGoogle Scholar
  15. Kano, M., and Takano, K., 1969, Gamma activity of rigid cat caused by tetanus toxin, Jap. J. Physiol. 19: 1.CrossRefGoogle Scholar
  16. Kanda, K., and Takano, K., 1983, Effect of tetanus toxin on the excitatory and inhibitory post-synaptic-potentials in the cat motoneurones, J. Physiol. 335: 319.PubMedGoogle Scholar
  17. Kanda, K., and Takano, K., 1984, An evidence for anterograde transport of tetanus toxin, in: Seventh Internat. Conf. on Tetanus, G. Nistico, P. Mastroeni, M. Pitzurra, eds., Gangemi Publ. Roma, 79.Google Scholar
  18. Kirchner, F., Riibesamen, V., and Takano, K., Adenosine phosphates concentration in the muscle during local tetanus, in: Ninth Internat. Congr. on Tetanus and Antiinfectious Defense, del Real, ed., (in the press).Google Scholar
  19. Kretzschmar, H., Kirchner, F., and Takano, K., 1980, Relations between the effect of tetanus toxin on the neuromuscular transmission and histological functional properties of various muscles of the rat, Exp. Brain Res. 38: 181.PubMedCrossRefGoogle Scholar
  20. Kryzhanovsky, G.N., 1967, The neural pathway of toxin: its transport to the central nervous system and the state of the spinal reflex apparatus in tetanus intoxication, in: Principles of Tetanus, L. Eckmann, ed., H. Huber, Bern, Stuttgart, 155.Google Scholar
  21. Kryzhanovsky, G.N., 1981, Pathophysiology, in: Tetanus, Important New Concepts, R. Veronesi, ed., Excerpta Medica, Amsterdam, Oxford, Princeton, 109.Google Scholar
  22. Kryzhanovsky, G.N., and Lutsenko, V.K., 1969, Dorsal root potential of the spinal cord in rats with convulsions due to ascending tetanus, Bull. Exp. Biol. Med. 67: 16.Google Scholar
  23. Laird, W.J., 1982, Botulinum toxin-like effects of tetanus toxin, in: Sixth Internat. Conf. on Tetanus, Foundation Merieux, Lyon, 33.Google Scholar
  24. Liljestrand, G., and Magnus, R., 1919, Liber die Wirkung des Novokains auf den normalens und den tetanusstarren Skelettmuskel und über die Entstehung der lokalen Muskelstarre beim Wundstarrkrampf, Pflügers Arch. 176: 168.CrossRefGoogle Scholar
  25. Matsuda, M., Sugimoto, and Ozutsumi, K., 1982, Acute botulinum-like intoxication by tetanus toxin in mice and the localization of the acute toxicity in the N-terminal papain-fragment of the toxin, in: Sixth Internat. Conf. on Tetanus, Foundation Merieux, Lyon, 21.Google Scholar
  26. Mellanby, J., and Green, J., 1981, Commentary. How does tetanus act? Neurosci. 6: 281.CrossRefGoogle Scholar
  27. Mizote, M., and Takano, K., 1984, Two kinds of discharge pattern of primary endings to FM muscle vibration in the tetanic cat, in: The Muscle Spindle, I.A. Boyd, M.H. Gladden, eds., The Macmillan Press Lond., 365.Google Scholar
  28. Rushworth, G., 1960, Spasticity and rigidity: an experimental study and review, J. Neurol. Neurosurg. Psychiat. 23: 99.PubMedCrossRefGoogle Scholar
  29. Struppler, A., 1990, Das Nervensystem, in: Pathophysiologie-Pathobiochemie, E. Lang, Ed., Enke, Stuttgart, 193.Google Scholar
  30. Sugimoto, N., Matsuda, M., Ohnuki, Y., Nakayama, T., and Imai, K., 1982, Neuromuscular blocking in acutely tetanus intoxicated mice, Biken J. 25: 21.PubMedGoogle Scholar
  31. Sundström, L., and Mellanby, J., 1989, Acute effects of tetanus toxin on granule cells of the dentate gyrus of the rat in vivo, in: Eighth Internat. Conf. on Tetanus, G. Nistico, B. Bizzini. B. Bytchenko, R. Triau, eds., Pythagora Press Rome, Milan, 149.Google Scholar
  32. Sundström, L., and Mellanby, J., 1990, Tetanus toxin blocks inhibition of granule cells in the dentate gyrus of the urethane-anaesthetized rat, Neurosc. 38: 621.CrossRefGoogle Scholar
  33. Takano, K., and Henatsch, H.D., 1973, Tension extension of the tetanus intoxicated muscle of the cat. Naunyn-Schmiedebergs Arch. Pharmacol. 276: 421.PubMedCrossRefGoogle Scholar
  34. Takano, K., and Kano, M., 1973, Gamma-bias of the muscle poisoned by tetanus toxin, Naunyn-Schmiedeberg’s Arch. Pharmacol. 276: 413.CrossRefGoogle Scholar
  35. Takano, K., and Kirchner, F., 1987, Pathogenesis of tetanus: clinically relevant new concepts. A mini review, in: Progress in Venom and Toxin Research, P. Gopalakrish nakone and C.K. Tan, eds., Singapore: Singapore National University, 680.Google Scholar
  36. Takano, K., Kirchner, F., Gremmelt, A., Matsuda, M., Ozutsumi, N., and Sugimoto, N., 1989a, Blocking effects of tetanus toxin and its Fragment CA-BI on the excitatory and inhibitory synapses on the spinal motoneurone of the cat, Toxicon 27: 385.PubMedCrossRefGoogle Scholar
  37. Takano, K., Kirchner, F., and Mizote, M., 1991, Intact inhibition of the stretch reflex during general tetanus, Toxicon 29: 201.PubMedCrossRefGoogle Scholar
  38. Takano, K., Kirchner, F., Terhaar, P., and Tiebert, B., 1983, Effect of tetanus toxin on the monosynaptic reflex, Naunyn-Schmiedeberg’s Arch. Pharmac. 323: 217.CrossRefGoogle Scholar
  39. Takano, K., Kirchner, F., Tiebert, B., and Terhaar, P., 1989b, Presynaptic inhibition of the monosynaptic reflex during local tetanus in the cat, Toxicon 27: 431.PubMedCrossRefGoogle Scholar
  40. Takano, K., and Mizote, M., 1985, Central and peripheral effects of tetanus toxin on the gamma motor system, a review, in: Seventh Internat. Conf. on Tetanus, G. Nistico, P. Mastroeni, M. Pitzurra, eds., Gangemi Publ. Roma, 101.Google Scholar
  41. Takano, K., and Student, J.C., 1978, Effect of diazepam on the gamma motor system indicated by the response of the muscle spindle of the triceps surae muscle of the decerebrate cat to the muscle stretch, Naunyn-Schmiedeberg’s Arch. Pharmacol. 302: 91.CrossRefGoogle Scholar
  42. Wellhöner, H.H., 1982, Tetanus neurotoxin, Rev. Physiol. Biochem. Pharmacol. 93: 1.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • Kohsi Takano
    • 1
  1. 1.Department of Pathoneurophysiology Faculty of MedicineUniversity of GöttingenGöttingenGermany

Personalised recommendations