Vinod Kumar Tewari, Abhishek Gupta, Devesh Johari and Lori Tewari
In tetanus patients Levodopa and Carbidopa combination (which is usually used to relieve the signs of extrapyramidal) causes respiratory muscles spasm relief thereby the need for sedatives is decreased and patient saved later on via central nervous system mechanism, by providing the inhibitory neurotransmitters at Anterior Horn cells. The tetanus toxin initially binds to peripheral nerve terminals then it retrogradely goes to CNS attaches with gangliosides at presynaptic inhibitory motor nerve endings, blocks glycine and gamma amino butyric acid (GABA) across the synaptic cleft.
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