Tetanus Complicated by Dysautonomia: A Case Report and Review of Management

Table 1

Grade	Severity	Symptoms
1	Mild	Mild to moderate trismus; general spasticity; no respiratory embarrassment; no spasms; little or no dysphagia.
2	Moderate	Moderate trismus; well-marked rigidity; mild to moderate but short spasms; moderate respiratory embarrassment with an increased respiratory rate greater than 30; mild dysphagia.
3	Severe	Severe trismus; generalized spasticity; reflex prolonged spasms; increased respiratory rate greater than 40; apnoeic spells; severe dysphagia; tachycardia greater than 120.
4	Very severe	Grade III and violent autonomic disturbances involving the cardiovascular system. Severe hypertension and tachycardia alternating with relative hypotension and bradycardia, either of which may be persistent.