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Definition Return to top
Opisthotonos is a condition in which the body is held in an abnormal posture. It usually involves rigidity and severe arching of the back, with the head thrown backward. If a person with opisthotonos lays on his or her back, only the back of the head and the heels would touch the supporting surface.
See: Abnormal posturing
Considerations Return to top
Opisthotonos is much more common in infants and children than in adults. It is also more exaggerated in infants and children because of their less mature nervous systems.
Causes Return to top
Opisthotonos may occur in infants with meningitis, where it is a sign of irritation of the membranes surrounding the brain and spinal cord (meninges).
It may also occur as a sign of depressed brain function or injury to the nervous system.
Other causes may include:
Drugs, particularly phenothiazines and other antipsychotic medications, can cause a side effect known as acute dystonic reaction. Opisthotonos may be part of this reaction.
In rare cases, infants born to women who drink large amounts of alcohol during pregnancy may have opisthotonus due to alcohol withdrawal.
Home Care Return to top
Hospital care is required for a person who develops opisthotonos.
When to Contact a Medical Professional Return to top
Go to the emergency room or call your local emergency number (such as 911) if this symptom occurs. Typically opisthotonos is a symptom that follows late in the course of other conditions, which are serious enough that medical attention will likely have already been sought.
What to Expect at Your Office Visit Return to top
This condition will be evaluated in a hospital setting. Emergency measures will be taken as appropriate.
The medical history will be obtained, and a physical examination will be performed.
Medical history questions documenting opisthotonos in detail may include:
The physical examination will include a complete assessment of the nervous system.
The cause of the opisthotonos will be suggested by the history and physical examination. Diagnostic tests may include:
References Return to top
Chiriboga CA. HIV, fetal alcohol and drug effects, and the battered child. In: Rowland LP, ed. Merritt’s Neurology. 11th ed. Baltimore, Md: Lippincott Williams & Wilkins; 2005:chap 168.Update Date: 4/21/2009 Updated by: Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.