WordNet

severe spasm in which the back arches and the head bends back and heels flex toward the back

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/30 03:17:46」(JST)

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Opisthotonus or opisthotonos, from Greek roots, ὄπισθεν, opisthen meaning "behind" and τόνος tonos meaning "tension", is a state of severe hyperextension and spasticity in which an individual's head, neck and spinal column enter into a complete "bridging" or "arching" position.^[1]^[2] This abnormal posturing is an extrapyramidal effect and is caused by spasm of the axial muscles along the spinal column.

Causes

It is seen in some cases of severe cerebral palsy and traumatic brain injury or as a result of the severe muscular spasms associated with tetanus. It can be a feature of severe acute hydrocephalus.

Opisthotonus can be produced experimentally in animals by transection of the midbrain (between the superior colliculus and the inferior colliculus), which results in severing all the corticoreticular fibers. Hyperextension occurs due to facilitation of the anterior reticulospinal tract caused by the inactivation of inhibitory corticoreticular fibers, which normally act upon the pons reticular formation. It has been shown to occur naturally only in birds and placental mammals.

Opisthotonus is more pronounced in infants. Opisthotonus in the neonate may be a symptom of meningitis, tetanus, severe kernicterus, or the rare Maple syrup urine disease. This marked extensor tone can cause infants to "rear backwards" and stiffen out as the mother or nurse attempts to hold or feed them. Opisthotonus can be induced by any attempt at movement such as smiling, feeding, vocalization, or by seizure activity. A similar tonic posturing may be seen in Sandifer syndrome. Individuals with opisthotonus are quite challenging to position, especially in wheelchairs and car seats.

Opisthotonus can sometimes be seen in lithium intoxication. It is a rare extrapyramidal side effect of phenothiazines, haloperidol, and metoclopramide.

Opisthotonus with the presence of the risus sardonicus is also a symptom of strychnine poisoning.

Opisthotonus is also described as a potential CNS symptom of heat stroke along with bizarre behavior, hallucinations, decerebrate rigidity, oculogyric crisis and cerebellar dysfunction.

Opisthotonus is seen with drowning victims - called the "Opisthotonic Death Pose". This pose is also common in complete dinosaur skeletal fossils and it has been suggested that this is due to the animal drowning or being immersed in water soon after death.^[3]

References

^ "opisthotonos". Merriam-Webster. Retrieved 7 April 2015.
^ "The Berkeley Science Review" (PDF). Retrieved 2009-08-08.
^ http://www.newscientist.com/article/dn21207-watery-secret-of-the-dinosaur-death-pose.html

External links

Opisthotonus at GPnotebook

UpToDate Contents

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1. 正期産児および後期早産児における非抱合型高ビリルビン血症の臨床症状 clinical manifestations of unconjugated hyperbilirubinemia in term and late preterm infants
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3. ストリキニーネ中毒 strychnine poisoning
4. 小児における嚥下障害の評価 evaluation of dysphagia in children
5. 狂犬病の臨床的特徴および診断 clinical manifestations and diagnosis of rabies

English Journal

Semiology of psychogenic nonepileptic seizures: age-related differences.

Alessi R, Vincentiis S, Rzezak P, Valente KD.SourceLaboratory of Clinical Neurophysiology, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
Epilepsy & behavior : E&B.Epilepsy Behav.2013 May;27(2):292-5. doi: 10.1016/j.yebeh.2013.02.003. Epub 2013 Mar 17.
The few studies addressing semiology of psychogenic nonepileptic seizures (PNES) in children showed that this group differs from adults, considering the classical signs described. Our study with systematic assessment provides a direct comparison of the classical signs of psychogenic nonepileptic sei
PMID 23507305

Clinical vs. bispectral index-guided propofol induction of anesthesia: A comparative study.

Arya S, Asthana V, Sharma JP.SourceDepartment of Anaesthesiology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
Saudi journal of anaesthesia.Saudi J Anaesth.2013 Jan;7(1):75-9. doi: 10.4103/1658-354X.109819.
BACKGROUND: Clinically optimized focusing of drug administration to specific need of patient with bispectral index (BIS) monitoring results in reduced dose and faster recovery of consciousness. This study was planned with an aim to study and compare the conventional clinical end point or BIS on the
PMID 23717237

A case of neonatal tetanus presented within 24 hours of life.

Chatterjee S, Hemram S, Bhattacharya S, Khuntdar BK.SourceMedinipur Medical College and Hospital, Medinipur, West Bengal, India. sayanchat_82@yahoo.co.in
Tropical doctor.Trop Doct.2013 Jan;43(1):43-5. doi: 10.1177/0049475512472434. Epub 2013 Feb 26.
Neonatal tetanus is still prevalent in developing countries such as India. Generally, neonatal tetanus is seen in babies of unimmunized mothers beyond the second day of life. A neonate presented to us on the 4th hour of birth with a periumbilical ulcer. The baby's antenatal and birth history was une
PMID 23443624

Japanese Journal

ミトコンドリア脳筋症(リー脳症)による体幹の捻転ジストニアにバクロフェン持続髄注療法が奏功した1例

松井利浩,伊丹尚多,宮田あい子,宮田広善
Functional neurosurgery : proceedings of the annual meeting of the Japan Society for Stereotactic and Functional Neurosurgery 49(1), 44-45, 2010-06-15
NAID 10029745240

犬におけるプロポフォール全静脈麻酔とイソフルレン吸入麻酔の覚醒に関する臨床的比較(外科学)

TSAI Yi-Chin,WANG Liang-Yi,YEH Lih-Seng
The journal of veterinary medical science 69(11), 1179-1182, 2007-11-25
手術や診断のための検査で麻酔をかけた149頭の飼育犬について,プロポフォールによる全静脈麻酔(TIVA)とイソフルレンによる吸入麻酔の覚醒時の特性を臨床的に比較した.すべての犬はアセプロマジンもしくはジアゼパムの前投与後,プロポフォールの静脈内投与により導入された.その結果,58頭のプロポフォール-TIVA麻酔群は91頭のイソフルレン吸入麻酔群よりも覚醒は遅延したが,円滑な覚醒を示した.麻酔終了後 …
NAID 110006452657

新生黒毛和種牛にみられた海綿状変化を伴う神経疾患の1例(病理学)

加藤浩一郎,内田和幸,村上隆之,立山晉
The journal of veterinary medical science 67(10), 1067-1070, 2005-10-25
出生時より起立不能, 後弓反張などの症状を示した生後3日齢, オスの黒毛和種牛を病理学的に検索した.組織学的に中枢神経にさまざまな形態を示す多数の空胞が神経網に観察され, 病変部は重度の海綿状態を呈していた.これらの空胞はホルマリン固定パラフィン標本, 凍結標本のいずれにおいても観察された.病変部では, 軽度の星状膠細胞増生を伴い, 少数の軸索球, マクロファージ浸潤がミエリン鞘内に観察された.こ …
NAID 110003983131

Related Pictures

★リンクテーブル★

リンク元	「tonic seizure」「強直性発作」「反弓緊張」

「tonic seizure」

Opisthotonus
	Opisthotonus in a patient suffering from tetanus. Painting by Sir Charles Bell, 1809.
Classification and external resources
ICD-9	781.0
DiseasesDB	31293
MedlinePlus	003195