Dysfunction of the sympathetic nervous system in tetanus

Hörtnagl, Heide; Brücke, T.; Hackl, J. M.

doi:10.1007/bf01480477

Cited by 12 publications

(11 citation statements)

References 18 publications

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“…The duration of this symptoms varied from a few days to two weeks [28]. Simultaneous disappearance of the tetanic spasms and the cardiovascular instability was also observed [24,26]. In some cases hypertension disappeared by the time the patient left hospital [29].…”

Section: Cardiovascular Disturbancesmentioning

confidence: 91%

“…Tachycardia above 140/min was exhibited by 65% of the patients, who finally died [32]. These cardiovascular symptoms are reported to initiate 2-10 days after the onset of trismus [7,12,16,23,24,28,30]. The duration of this symptoms varied from a few days to two weeks [28].…”

Section: Cardiovascular Disturbancesmentioning

confidence: 94%

“…A high level of catecholamines may explain the presence of glycosuria and hyperglycaemia in some patients with tetanus by glycogenolysis and gluconeogenesis [32]. Extremely high plasma levels of catecholamines could be detected during a period of pronounced hyperglycaemia [24]. Again in patients with phaeochromocytoma, a similar disarrangement of carbohydrate metabolism has been found [47].…”

Section: Disorders Of the Gastrointestinal Tractmentioning

confidence: 95%

“…In a further study it could be demonstrated that elevated plasma levels of noradrenaline were present as long as there existed signs of disturbances of the motor system [24]. In a patient with severe tetanus very high levels of noradrenaline as well as adrenaline persisted beginning at the 3rd day after the onset of trismus until the 12th day when the patient died suddenly [24].…”

Section: Catecholamine Levels In Patients With Tetanusmentioning

confidence: 95%

“…These observations were confirmed subsequently by a number of other studies. Elevated levels of catecholamines in plasma and urine could be demonstrated in patients with severe tetanus [7,24,26,27,28] indicating a sustained overactivity of the sympathetic nervous system.…”

Section: Die Beteiligung Des Sympathischen Nervensystems Bei Tetanusmentioning

confidence: 98%

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The involvement of the sympathetic nervous system in tetanus

1979

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Besides the characteristic disturbances of the motor nervous system symptoms indicating an overactivity of the sympathetic nervous system can complicate the course of severe cases of tetanus. These symptoms include fluctuating tachycardia and hypertension, electrocardiographic changes, sweating, constipation with development of paralytic ileus and metabolic disorders. These symptoms are comparable to these developing in patients with phaeochromocytoma. Elevated catecholamine levels in plasma and urine have been found in several patients with tetanus who developed these symptoms. The prolonged over-activity of the sympathetic nervous system is thought to contribute to the still considerably high mortality rate. Myocardial lesions observed at necropsy are comparable to those found in patients dying of phaeochromocytoma. These lesions are suggested to be associated with sudden death from arrhythmias or cardiac failure in patients with tetanus. For the protection of the organism against the overactivity of the sympathetic nervous system a treatment using the combination of beta-adrenergic receptor blocking agents and adrenergic neuron blocking agents has been introduced. A reduction of the mortality rate was achievable by this treatment. Experimental evidence is accumulating that the tetanus toxin affects not only the motor, but also the sympathetic and sensory neurons.

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Section: Cardiovascular Disturbancesmentioning

confidence: 91%

Section: Cardiovascular Disturbancesmentioning

confidence: 94%

Section: Disorders Of the Gastrointestinal Tractmentioning

confidence: 95%

Section: Catecholamine Levels In Patients With Tetanusmentioning

confidence: 95%

Section: Die Beteiligung Des Sympathischen Nervensystems Bei Tetanusmentioning

confidence: 98%

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The involvement of the sympathetic nervous system in tetanus

1979

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Neuroleptanalgesia in acute myocardial infarction: Effects of hemodynamic parameters and plasma catecholamines

Magometschnigg

Hörtnagl

Gaßner

et al. 1981

Clinical Cardiology

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Summary: The use of neuroleptanalgesia in acute myocardial infarction offers the possibility of reducing pain and emotional stress. The influence of such treatment on hemodynamic parameters (heart rate, cardiac output, stroke volume, peripheral resistance, systemic blood pressure, and pulmonary pressure) and on the plasma level of adrenaline and noradrenaline has been studied in 6 patients with acute myocardial infarction. The results demonstrate that during neuroleptanalgesia the already elevated levels of noradrenaline and adrenaline further increase. This increase was most pronounced in the patients with the highest initial levels of catecholamines. Since the peripheral resistance and systolic and diastolic blood pressures decrease concomitantly, it is concluded that the increase in plasma catecholamines is due to a reaction of the sympathetic nervous system to the alpha-adrenergic receptor blocking activity of droperidol causing vasodilation. The data indicate that pain, emotional stress, and anxiety in the acute phase of myocardial infarction do not play the expected essential role for the activation of the sympathetic nervous system generally observed in acute myocardial infarction. Additionally, the data demonstrate that drugs producing a vasodilation can have a deteriorating effect on the hemodynamic situation and that a reduction of the afterload by vasodilating drugs can result in a further increase in the release of catecholamines.

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