Opisthotonus is seen in poisoning with -
Clinical features of STRYCHNOS NUX VOMICA * If seeds are swallowed uncrushed, the hard pericarp resist digestion and seeds are passed in feces without any poisonous symptoms. * With crushed seeds, symptoms begin to appear within 15 to 30 minutes. * Bitter taste in mouth * Sense of uneasiness, restlessness, fear and anxiety * Increase difficulty in breathing and swallowing * Muscle twitching and spasm of muscle followed by convulsions. The convulsions last for 30 seconds to 2 minute and are precipitated by slightest stimuli such as sudden noise, a current of air or gentle touching of patient. The convulsions are first clonic but eventually becomes tonic. In between the convulsions, the muscles are completely relaxed and it is an impoant diagnostic feature. * The convulsions are more marked in anti-gravity muscles and body arches in hyperextension position and lies on heel and head. This position of body is known as opisthotonos. It is most common position. However, at time, the body may bend forward and the condition is called as emprosthotonos. If body bends side wise (i.e. lateral bending), the condition is called as pleurothotonos. * Contraction of the muscles of face causes widening of the angle of mouth with creases appearing around eyelids. This condition is known as risus sardonicus. Also called as sardonic smile due to grimacing that occurred due to muscle contraction of face. * There is difficulty in breathing during convulsions due to contraction of chest muscles and diaphragm. * Patient remains conscious and maintains clear sensorium during and between convulsions. * There may be frothing at mouth and pupils are dilated * Prognosis is good if interval for appearance of convulsions increases and period of convulsion decreases. Prognosis is bad if reverse occurs, i.e. when convulsions appear rapidly and last longer. REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION;PAGE NO 352
Opium
Strychnine
Snake
Scorpion
Poisoning