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Abstract
In a 16-year nationwide study in Finland 106 patients were diagnosed as having tetanus. Tetanus was diagnosed on the first visit to a doctor in half the patients, it was suspected in 28 % but not considered in 22 %. Diagnosis of tetanus may be delayed if a patient is elderly or has no known primary lesion. Abnormal EEGs and CSF findings with increased protein level were unexpectedly common (76 % and 24 % respectively). The most significant complications were cardiac arrhythmias (34 %), blood pressure lability (32 %), an increased haemorrhagic tendency (28 %), an increase in thrombosis (8 %) and/or of anoxic periods (16 %) and death (11 %). Intensive care has markedly improved the prognosis of tetanus; the main problems at present are difficulty of early diagnosis and treatment of complications of the most serious cases.