THE STAPEDIAL REFLEX IN CEPHALIC TETANUS

Three patients are presented with cephalic tetanus following injuries to the face. Two were adults and one a child. All three had bilateral VIIth cranial nerve involvment and one patient also presented with inv olvement of the IIIrd, IVth and VIth cranial nerves. The patients init ially an ipsilateral VIIth nerve weakness which later in the course of the illness developed hyperactivity of the VIIth cranial nerve. The c ontralateral VIIth cranial nerve demonstrated a similar pattern. The s tapedial reflex was tested serially. The stapedius muscle activity pre ceded that of the muscles of the face thus serving as an indicator of improvement or impending deterioration. Deflections measuring more tha n 1 cm, on stapedial reflex threshold testing, were indicative of stap edial reflex spasm. In the stapedial reflex decay test, both ill-susta ined (intermittent) and sustained spasms of the stapedius muscle were seen.