DR Medhat MRCP

Latent tetany
+ve Provocative tests
1) Trousseau's sign:
- Carpal spasm if the brachial artery
occluded by inflating the blood pressure
cuff and maintaining pressure above
systolic.
- Wrist flexion and fingers drawn together
- Seen in around 95% of patients with
hypocalcemia and around 1% of
normocalcaemic people
Manifest tetany
1) Neural excitability :
- Irritability
- Perioral parathesia (tingling)
2) Muscular excitability
- Muscle twitches convulsions
- Carpo-pedal spasm.
- Spasm of other muscles e.g
a) Larynx : laryngismus
stridulus.
b) Masseter : trismus.
c) Diaphragm : hiccough.
d) GIT : abdominal colic.
2) Chvostek's sign:
- Tapping over parotid causes facial
muscles to twitch.
- Seen in around 70% of patients with
hypocalcemia and around 10% of
normocalcaemic people.
Carpal spasm
Trismus
Trousseau's sign is more sensitive and
specific than Chvostek's sign