When tetanus occurs, early symptoms mainly include dizziness, headache, fatigue, decreased appetite, weak chewing, sore jaw muscles, or tense facial muscles. Some cases show exaggerated reflexes or muscle tension. Generally, tetanus has its typical manifestations, such as difficulty in opening the mouth, risus sardonicus (a sardonic smile), opisthotonus (arching of the back), and stiff neck. In clinical practice, a few cases may even have a fever. Therefore, fever in tetanus is only seen in individual cases.