[Electromyography as a diagnostic aid in tetanus].

In developing countries tetanus is still a real problem because of its high incidence and mortality. In all countries with high medical standards it has become rare. For this reason many clinicians are no longer familiar with the disease and its diagnosis. Until now no laboratory test has been readily available to confirm or rule out tetanus. However, the diagnosis can be performed by a simple and readily available electromyogram (EMG). We performed EMGs in 13 patients in whom tetanus was suspected but whose case history or clinical findings left some doubt. In 7 cases the EMG was typical for tetanus, showing spontaneous activity of motor units which could not be suppressed voluntarily and with shortening or absence of the silent period after a stretch reflex or after electrical stimulation of the nerve. In 2 cases we found one of the two diagnostic features. In all these 9 cases the diagnosis of tetanus was confirmed by the further development of the disease. In the remaining 4 patients the EMG was normal and in the course it was confirmed that they were not suffering from tetanus. Therefore, we consider electromyography a very useful and reliable tool either to confirm or rule out the diagnosis of tetanus.