Opisthotonus

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Opisthotonus. Opisthotonus is forceful axial extension of the trunk and neck (retrocollis). Fully referenced neurology checklist.

Clinical features

  • Opisthotonus is forceful axial extension of the trunk and neck (retrocollis)
  • It is caused by involuntary contractions of the paraspinal muscles
  • It is usually associated with dystonic posturing of the limbs

Neurological causes

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Tardive causes (tardive dystonia)

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Infectious causes

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Metabolic causes

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Systemic causes

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Treatment

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Synonym

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References

  1. Hull M, Parnes M, Jankovic J. Botulinum neurotoxin injections in childhood opisthotonus. Toxins (Basel) 2021; 13:137.
  2. Bavdhankar K, Joshi R, Maheshkar P, Agrawal S, Jain N, Ravat SH, Agarwal PA. Prominent extensor truncal dystonia (dystonic opisthotonus) in DJ1-related atypical dystonia-parkinsonism. Parkinsonism Relat Disord 2025; 137:107899.
  3. Gurram S, Holla VV, Kumari R, et al. Dystonic opisthotonus in Kufor-Rakeb syndrome: expanding the phenotypic and genotypic spectrum. J Mov Disord 2023; 16:343-346.
  4. Constantini S, Beni L. Reversible opisthotonus following intracranial pressure changes in Chiari malformation. Childs Nerv Syst 1993; 9:350-352.
  5. Ersahin Y, Mutluer S, Güzelbag E. A case of double-compartment hydrocephalus presenting with opisthotonus. Surg Neurol 1992; 38:291-293.
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