TETANY

• Tetany is a condition with hyperexcitability of peripheral nerves due to hypocalcemia resulting in spasm of hands, feet.

ETIOLOGY-

• Hypoparathyroidism
• Severe respiratory alkalosis
• Dietary factors
• Deficiency of Vitamin D
• Hypokalaemic alkalosis
• Acute pancreatitis
• Hypomagnesemia
• Strychnine
• Hyperaldosteronism
• Chelation of calcium
• Hyperventilation
• Malabsorption

CLINICAL FEATURES-

• Tingling and numbness of lips, nose, extremities.
• Painful cramps of hands, feet.
• In severe hypocalcemia, adduction of thumb is a common feature and along with strong extension of the feet results in “Carpopedal spasm”.

• Metacarpophalangeal joints are flexed, interphalangeal joints are extended and thumb is adducted called as thumb in palm deformity (Obstetrician’s hand)

• Stridor, dyspnoea, blurring of vision.
• Common signs associated with tetany are-

a) Chvostek- Weiss sign-

• Gentle tap on facial nerve produces twitching of eyelids, corner of mouth (same side of face)

• A sphygmomanometer cuff  applied to the arm and pressure is raised to 200 mm Hg, hands and feet go into spasm.

INVESTIGATIONS-

• Serum calcium level with is usually

TREATMENT-

• Oral calcium- mild symptoms
• Acute condition- injection calcium gluconate 10%

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