Autism and Clostridium tetani

Med Hypotheses. 1998 Aug;51(2):133-44. doi: 10.1016/s0306-9877(98)90107-4.


Autism is a severe developmental disability believed to have multiple etiologies. This paper outlines the possibility of a subacute, chronic tetanus infection of the intestinal tract as the underlying cause for symptoms of autism observed in some individuals. A significant percentage of individuals with autism have a history of extensive antibiotic use. Oral antibiotics significantly disrupt protective intestinal microbiota, creating a favorable environment for colonization by opportunistic pathogens. Clostridium tetani is an ubiquitous anaerobic bacillus that produces a potent neurotoxin. Intestinal colonization by C. tetani, and subsequent neurotoxin release, have been demonstrated in laboratory animals which were fed vegetative cells. The vagus nerve is capable of transporting tetanus neurotoxin (TeNT) and provides a route of ascent from the intestinal tract to the CNS. This route bypasses TeNT's normal preferential binding sites in the spinal cord, and therefore the symptoms of a typical tetanus infection are not evident. Once in the brain, TeNT disrupts the release of neurotransmitters by the proteolytic cleavage of synaptobrevin, a synaptic vesicle membrane protein. This inhibition of neurotransmitter release would explain a wide variety of behavioral deficits apparent in autism. Lab animals injected in the brain with TeNT have exhibited many of these behaviors. Some children with autism have also shown a significant reduction in stereotyped behaviors when treated with antimicrobials effective against intestinal clostridia. When viewed as sequelae to a subacute, chronic tetanus infection, many of the puzzling abnormalities of autism have a logical basis. A review of atypical tetanus cases, and strategies to test the validity of this paper's hypothesis, are included.

Publication types

  • Review

MeSH terms

  • Autistic Disorder / etiology*
  • Autistic Disorder / physiopathology
  • Autistic Disorder / psychology
  • Brain / microbiology
  • Clostridium / physiology*
  • Clostridium tetani / pathogenicity*
  • Humans
  • Intestines / microbiology
  • Models, Biological
  • Models, Psychological
  • Opportunistic Infections / psychology*
  • Tetanus / complications*
  • Tetanus / psychology
  • Tetanus Toxin* / pharmacokinetics
  • Vagus Nerve / physiopathology


  • Tetanus Toxin