Tétanos Céphalique : A Propos d’un Cas Malagasy

 [Cephalic Tetanus: A Malagasy Case Report]A 30-year-old man presented with a lockjaw and dysphagia for two days. He mentioned a history of supraorbital wound, due to bicycle accident, eighteen days before his presentation to our hospital. His vaccination status was not known. Initial assessment showed palsies of right cranial nerves VII and III. At thirty six hours after his arrival, painful contractions of the extensor muscle of the neck and back occurred. The patient progressed to the systemic muscular rigidity. A diagnosis of CT evolving towards generalized form. We administered antibiotics, intravenous antitoxin, muscle relaxant and a single dose of tetanus toxoid. His follow up visit after 1 month found improvement of lockjaw and dysphagia. His facial nerve palsy required reeducation.The diagnosis of CT is exclusively based on clinical findings. CT should be suspected in all cases who vaccination status is not updated or not known, presenting lockjaw with palsies of one or more cranial nerves. Early management improve the prognosis