What Is Opisthotonos?

Medically Reviewed by Christopher Melinosky, MD on March 07, 2024
Written by Nicole Wu
3 min read

Opisthotonos is the term that describes an abnormal posture that happens when the muscles in your neck, back, and legs spasm and contract. These contractions cause your body to bend backward into a rigid arch, with your head pointing toward your feet. 

Opisthotonos is not by itself a disease or disorder, but a symptom of many different serious health problems or conditions. Here is what you need to know about opisthotonos. 

Opisthotonos can be a symptom of several different health conditions, including:

  • Infections such as tetanus, rabies, encephalitis, meningitis, malaria, and syphilis in the brain 
  • Strychnine poisoning
  • An overdose of tranquilizing or anesthetic drugs like phencyclidine, lignocaine, methoxphenidine, and propofol 
  • Genetic conditions such as Gaucher disease, Krabbe disease, and maple syrup urine disease
  • Diseases that damage the brain like cerebral palsy, Wilson's disease, and Parkinson’s disease 
  • Jaundice (hyperbilirubinemia) or related brain damage (kernicterus)
  • Pressure on the brain from excess fluid (hydrocephalus), bleeding (hemorrhage), or other injuries
  • Lack of oxygen to the brain after cardiac arrest, suffocation, or near-drowning 

The distinctly arched, abnormal posture is the key sign of opisthotonos. People with opisthotonic posture will form a stiff “C” shape with their bodies. Their necks and backs will be bent backward with their head pointing toward their feet.

Since opisthotonos is a sign of other health issues, people with the condition can have a variety of other symptoms depending on the root cause. Some other reported symptoms that frequently appear alongside opisthotonos include:

  • Fever
  • Intense muscle pain
  • Fatigue
  • Problems eating or drinking
  • Fast or irregular heartbeat
  • Dilated pupils
  • Excessive sweating
  • Blood pressure irregularity
  • Breathing trouble
  • Vomiting
  • Seizures

Opisthotonos is a fairly rare side effect of many different health problems. It can affect both male and female people of all ages, from infants to adults.

Your doctor can perform a physical exam to diagnose the muscle spasm and contractions that cause opisthotonos. Diagnosing opisthotonos can often be especially difficult in infants and young children if they are crying or have developed other muscle spasms.

Finding the underlying cause of opisthotonos will require other tests and exams. Depending on your other symptoms, your doctor might want to perform various blood tests, an MRI of your brain, or a lumbar puncture (spinal tap) to diagnose your underlying condition. 

Opisthotonos treatment methods will depend on the underlying disease or health problem that is causing your muscle spasms and abnormal posture.

For opisthotonos caused by an infectious disease such as tetanus or rabies, you will be given immune globulins, which are antibodies made from the blood of people who have already had the disease. The immune globulins work alongside your immune system to help fight off the infection. 

People with Gaucher disease can be treated with enzyme replacement therapy to help manage the buildup of lipids (a type of fatty substance) in their blood.

People with Parkinson’s disease might be given a type of deep brain stimulation to help control their involuntary spasms that can cause opisthotonos.  

If your opisthotonos is caused by fluid buildup or pressure in your brain, a hollow tube called a shunt might be inserted to help drain the fluid. 

People with opisthotonos will also need supportive care to help their body maintain its normal functions while the underlying disease is being treated. This often includes giving medication for pain relief, regulating breathing, monitoring fluid and electrolyte intake, and making sure patients get the nutrition they need. 

Certain medications like benzodiazepines or baclofen are also sometimes given to help relieve muscle spasms.

 Early diagnosis can make a big impact on your recovery and possible outcomes. If not treated promptly or properly, opisthotonos can lead to neurological issues, developmental delays in infants and children, malnutrition, spinal deformity, coma, and even death.

You can prevent opisthotonos by first preventing or managing the underlying disease or health conditions that cause it. Some general tips to help prevent opisthotonos are:

  • Make sure to monitor your blood pressure and blood sugar levels and keep them within a healthy range. 
  • Remember to maintain good hygiene and cleaning practices. 
  • Stay up to date on tetanus and meningitis vaccines to decrease your chances of catching those diseases. 
  • Keep an open line of communication with your doctor and report any symptoms or health problems you experience.