The correct option is D All of the above.
Tetanus or lockjaw is an infection characterized by muscle spasms. It is caused by an infection with the bacteria Clostridium tetani.
Back muscle spasms often cause arcing called as opisthotonos.
The first sign is trismus or lockjaw and the facial spasms called as risus sardonicus (which is a highly characteristic, abnormal, sustained spasm of the facial muscles that appears to produce grinning).
Therefore, the correct answer is option D.