Tetanus is a serious disease that has become rare in countries that adopt an effective and sustainable vaccination strategy; however, tetanus remains a fairly common problem in developing countries. The diagnosis of tetanus is fairly easy. However, its cephalic form is a rare but potentially life-threatening neurological condition caused by the bacteria Clostridium tetani, which can result in symptoms such as spasms, rigidity, and paralysis of various muscles and nerves in the head and neck region.This article is about a 43-year-old man who had presumed an idiopathic facial palsy at the beginning and who turned out after the evolution of the clinical picture that it is cephalic tetanus. In this article, we will see the subtleties and clinical elements that have allowed us to rectify the diagnosis. Peripheral facial palsy can be a presenting symptom of cephalic tetanus and should be considered in patients with a history of tetanus infection or exposure. Early recognition and prompt treatment of cephalic tetanus are crucial in preventing complications and improving outcomes. Treatment typically involves the administration of tetanus immunoglobulin and antibiotics, as well as supportive care for any associated symptoms or complications.

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