Table 1 Ablett classification of tetanus severity [7]
Grade | Clinical manifestation |
|---|---|
I (mild) | Mild to moderate trismus Generalized spasticity No respiratory compromise No spasms Little or no dysphagia |
II (moderate) | Moderate trismus Marked rigidity Mild to moderate but short spasms Moderate respiratory compromise with an increased respiratory rate (> 30 breaths per min) Mild dysphagia |
III (severe) | Severe trismus Generalized spasticity Reflex prolonged spasms Increased respiratory rate (> 40 breaths per min) apneic spells Severe dysphagia Tachycardia (> 120 beats per min) |
IV (very severe) | Clinical features of grade 3 tetanus Violent autonomic disturbances involving the cardiovascular system Severe hypertension and tachycardia alternating with relative hypotension and bradycardia (either of which might be persistent) |