Abnormalities of the silent period (SP) and blink reflexes occur in diseases that interfere with inhibitory pathways, such as tetanus and stiff-person syndrome (SPS). The SP is abnormal in tetanus but not in SPS. Studies of the blink reflex in tetanus are limited. In this report, a patient with generalized tetanus is described. The masseteric-and mixed-nerve SP was absent or truncated. In contrast to SPS, blink reflex studies revealed no bilateral R1 component, and a discrete R3 was only present ipsilateral to right supraorbital stimulation. This reflects the distinct inhibitory pathways underlying these disorders.
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