Signs in Hypocalcemia | Chvostek Sign & Trousseau Sign
๐ Buy my Premium ENT Notes
Instant access to 270+ high-yield ENT notes, plus updates during your access period.
๐ฎ๐ณ For Indian Students
ยท To buy all my notes, click here๐ก This post is a free outline of my YouTube video. Get my full handwritten notes using the links above.
Signs in Hypocalcemia
Two classical signs are associated with hypocalcemia. In this post, we will discuss:
- Chvostek Sign
- Trousseau Sign
โญ In ENT, these signs are commonly looked for in post-thyroidectomy patients, where the parathyroids may have been accidentally removed or injured.
Chvostek Sign
๐ Type of Sign
๐ Clinical Sign elicited by tapping the facial nerve.
๐ What is the Sign?
Chvostek Sign refers to twitching of the facial muscles on tapping over the facial nerve.
Seen in Hypocalcemia.
๐ฉบ How is it Elicited?
The examiner taps over the facial nerve at the angle of the jaw, just in front of the tragus.
A positive sign is:
โ Twitching of the ipsilateral facial muscles at the corner of the lip, the nose and the eyelid
๐ง Why Does it Occur?
Reduced serum calcium levels
โ Lowered threshold for nerve excitation
โ Increased neuronal excitability
โ Facial nerve becomes hyper-responsive to even a low threshold stimulus
โ Twitching of the facial muscles on tapping
โญ Indicates increased neuromuscular excitability.
๐จโโ๏ธ Eponym
Named after Frantiลกek Chvostek, who first described the facial muscle twitching seen in hypocalcemia.
Trousseau Sign
๐ Type of Sign
๐ Clinical Sign elicited using a Blood pressure cuff.
๐ Also Known As
๐ Obstetrician's Hand
๐ What is the Sign?
Trousseau Sign refers to a painful carpopedal spasm induced by occluding the blood flow with a blood pressure cuff.
Seen in Hypocalcemia.
๐ฉบ How is it Elicited?
1- A blood pressure cuff is applied to the arm
2- The cuff is inflated above the systolic blood pressure
3- Pressure is maintained for 3โ5 minutes
A positive sign is:
โ Painful carpopedal spasm
What are the features of the Carpopedal Spasm?
๐ง Why Does it Occur?
Reduced serum calcium levels
โ Lowered threshold for nerve excitation
โ Increased nerve and muscle excitability
Cuff inflation causes ischemia, which triggers the spasm, leading to latent tetany.
โญ Indicates neuromuscular irritability.
๐จโโ๏ธ Eponym
Named after Armand Trousseau, who described the carpopedal spasm seen in hypocalcemia.
What is Trousseau Syndrome?
Which is the more sensitive sign of hypocalcemia - Chvostek sign or Trosseau sign?
What is the most common ENT cause of hypocalcemia?
What are the complications of thyroidectomy?
โญ High Yield Rapid Revision Table
| Sign | Elicited By | Finding | Indicates |
|---|---|---|---|
| Chvostek Sign | Tapping the facial nerve in front of the tragus | Twitching of ipsilateral facial muscles | Increased neuromuscular excitability |
| Trousseau Sign | BP cuff inflated above systolic pressure for 3โ5 minutes | Painful carpopedal spasm (Obstetrician's hand) | Neuromuscular irritability, latent tetany |
๐ง Viva Pearls
- Chvostek Sign and Trousseau Sign are seen in hypocalcemia.
- Chvostek Sign is elicited by tapping over the facial nerve at the angle of the jaw, just in front of the tragus.
- Chvostek Sign is twitching of the ipsilateral facial muscles.
- Trousseau Sign is elicited by inflating a BP cuff above systolic pressure for 3โ5 minutes.
- Trousseau Sign is a painful carpopedal spasm, also called obstetrician's hand.
- Both signs occur due to a lowered threshold for nerve excitation in hypocalcemia.
๐ All topics and questions from this post are explained in detail in my Premium ENT Notes, which are designed for clinical understanding and exam success.
Residency is hard enough. Studying for it shouldn't be ๐
๐ Buy my Premium ENT Notes
Instant access to 270+ high-yield ENT notes, plus updates during your access period.
๐ฎ๐ณ For Indian Students
ยท To buy all my notes, click here