Trousseau's sign of latent tetany

Clinical sign of latent tetany

Trousseau's sign of latent tetany
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Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Muscle spasms in the hand and forearm
Complications	N/A
Onset	N/A
Duration	N/A
Types	N/A
Causes	Hypocalcemia
Risks	N/A
Diagnosis	Physical examination
Differential diagnosis	N/A
Prevention	N/A
Treatment	Address underlying cause of hypocalcemia
Medication	N/A
Prognosis	N/A
Frequency	N/A
Deaths	N/A

Trousseau's sign of latent tetany is a clinical sign that indicates the presence of latent tetany due to hypocalcemia, or low calcium levels in the blood. It is named after the French physician Armand Trousseau, who described the phenomenon in the 19th century.

Pathophysiology

Trousseau's sign is associated with hypocalcemia, a condition where there is an abnormally low level of calcium in the blood. Calcium plays a crucial role in muscle contraction and nerve function. When calcium levels are low, the stability of the neuronal membranes is affected, leading to increased excitability of nerves and muscles. This can result in involuntary muscle contractions or spasms, known as tetany.

Clinical Presentation

To elicit Trousseau's sign, a healthcare provider inflates a blood pressure cuff around the patient's arm to a level above the systolic blood pressure and maintains it for about 3 minutes. In the presence of hypocalcemia, this maneuver will induce carpal spasm, characterized by flexion of the wrist and metacarpophalangeal joints, extension of the interphalangeal joints, and adduction of the thumb. This is sometimes referred to as "main d'accoucheur" or "obstetrician's hand" due to the hand's resemblance to the position used by an obstetrician during delivery.

Diagnosis

Trousseau's sign is a physical examination finding that suggests the presence of hypocalcemia. It is often used in conjunction with other clinical signs, such as Chvostek's sign, and laboratory tests to confirm the diagnosis of hypocalcemia. Blood tests measuring serum calcium, magnesium, and phosphate levels are typically performed to identify the underlying cause of the electrolyte imbalance.

Causes

The most common causes of hypocalcemia leading to Trousseau's sign include:

• Hypoparathyroidism
• Vitamin D deficiency
• Chronic kidney disease
• Acute pancreatitis
• Certain medications, such as bisphosphonates

Management

The management of Trousseau's sign involves addressing the underlying cause of hypocalcemia. Treatment may include:

• Calcium supplementation, either orally or intravenously
• Vitamin D supplementation
• Treatment of underlying conditions, such as hypoparathyroidism or kidney disease

Also see

• Chvostek's sign
• Hypocalcemia
• Tetany
• Hypoparathyroidism