Sample size was calculated using OpenEpi software 10 with 80% power of test and 5% level of significance considering 20% case fatality rate of tetanus.1 Patients with acute
hypertonia of other causes (e.g.
Developmental delay was not observed until the age of 6 months, at which time he demonstrated a lack of head control, poor eye contact, and lower limb
hypertonia. At the age of 9 months, he was referred to our hospital for etiologic diagnosis.
Decreases in the rate ofhead growth postnatally in these infants can be associated with significant neurologic dysfunction, including
hypertonia and hemiparesis, dyskinesia, dysphagia, epilepsy, and persistence of primitive reflexes.
Rekate et al (12) reported four cases diagnosed with Chiari malformation who were suffering from intermittent hyperinsulinemic hypoglycemia and proposed that vagal
hypertonia, caused by variation in intracranial pressure, affected the pancreas leading to hypoglycemia in their patients.
In addition, FES can reduce
hypertonia and complications of immobilization (6, 8).
Traditional surgical procedures; manual anal dilatation or internal lateral sphincterotomy have been commonly used to reduce the
hypertonia of the internal anal sphincter but they carry risk of permanent impairment of anal continence.
Hypertonia, or excessively high muscle tone, is characterized by trembling, involuntary motions, stiffness and/or inflexibility; hypotonia, or low muscle tone, is manifested in body postures such as a sunken chest and drooping head.
(4) This involvement is characterized by osteoarticular deformities (kyphosis, scoliosis, knee valgus, and equinus foot), joint stiffness with loss of range of motion (ROM), and upper motor neuron impairment (myelopathy,
hypertonia, and spasticity).
At that time, a physical and neurological examination was notable for an altered level of consciousness, irregular breathing,
hypertonia, central rigidity, and exaggerated Moro reflex, as well as jaundiced skin.