From the Guidelines
Tetany is a medical condition characterized by involuntary muscle contractions, spasms, and cramps, typically caused by abnormally low calcium levels in the blood (hypocalcemia), as seen in early neonatal hypocalcaemia which is common and generally not associated with obvious clinical problems such as tetany 1.
Definition and Causes
Tetany occurs due to low calcium levels in the blood or alkalosis, and its symptoms can include carpopedal spasm, muscle twitching, and tingling around the mouth. According to the guidelines on pediatric parenteral nutrition, calcium infusion may be used for prevention and treatment of early neonatal hypocalcaemia 1.
Diagnosis and Treatment
Diagnosis of tetany can be made through physical examination, including tests like Trousseau's sign and Chvostek's sign. Treatment focuses on addressing the underlying cause, typically by correcting calcium levels with oral or intravenous calcium supplements, as stated in the guidelines that Ca infusion will usually prevent or treat early neonatal hypocalcaemia 1.
Key Points
- Tetany is characterized by involuntary muscle contractions and spasms
- It is typically caused by low calcium levels in the blood or alkalosis
- Symptoms include carpopedal spasm, muscle twitching, and tingling around the mouth
- Diagnosis is made through physical examination and tests like Trousseau's sign and Chvostek's sign
- Treatment involves correcting calcium levels with oral or intravenous calcium supplements, as recommended in the guidelines 1
From the Research
Definition of Tetany
- Tetany is a series of symptoms characterized by painful muscle cramp that derives from enhanced neuromuscular excitability due to hypocalcemia, hypomagnesemia, or alkalosis 2.
- It is a consequence of severely lowered calcium levels, usually in patients with chronic hypocalcemia 3.
- Tetany can be regarded as an expression of hyperexcitability of the nerve cells from some cause, such as a disturbance of the composition of the circulating fluids ordinarily prevented by the secretion of the parathyroid 4.
Causes of Tetany
- Hypocalcemia, which can be caused by a lack of parathyroid hormone (PTH), vitamin D deficiency, or resistance to PTH 3, 2, 5.
- Hypomagnesemia, which can cause hypocalcemia and tetany due to peripheral parathyroid hormone resistance and impaired parathyroid hormone secretion 6.
- Metabolic and respiratory alkalosis, which can reduce ionized calcium levels and cause tetany 6.
- Certain diseases, such as Gitelman syndrome, primary hyperaldosteronism, and hyperventilation syndrome 6.
- Drugs, such as bisphosphonates, denosumab, cisplatin, antiepileptics, aminoglycosides, and diuretics 6.
Symptoms of Tetany
- Painful muscle cramp 2.
- Carpopedal spasm, laryngospasm, and generalized seizure 2.
- Sensory disturbance 2.
- Chvostek and Trousseau signs are provocative tests for diagnosis of latent tetany 2.
Treatment of Tetany
- Infusion of calcium or magnesium is effective as an acute therapy for tetany 2.
- Subsequent diagnosis and treatment of underlying diseases are mandatory 2.
- Vitamin D supplementation is necessary for patients with vitamin D deficiency 5.
- Treatment of underlying conditions, such as hypoparathyroidism, pseudohypoparathyroidism, and hypomagnesemia, is necessary to prevent tetany 6.