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Title: Tetany  
Author: World Heritage Encyclopedia
Language: English
Subject: Trismus, Trousseau sign of latent tetany, Sanjad-Sakati syndrome, Barakat syndrome, Hyperventilation
Collection: Symptoms and Signs: Nervous System, Tetanus
Publisher: World Heritage Encyclopedia


Classification and external resources
ICD-10 R29.0
ICD-9-CM 781.7
DiseasesDB 29143
MeSH D013746

Tetany or tetany seizure is a medical sign consisting of the involuntary contraction of muscles, which may be caused by disease or other conditions that increase the action potential frequency of muscle cells or the nerves that innervate them. Muscle cramps which are caused by the disease tetanus are not classified as tetany; rather, they are due to a lack of inhibition to the neurons that supply muscles.


  • Pathophysiology 1
  • Causes 2
  • Diagnosis 3
  • References 4
  • Further reading 5


  • Hypocalcemia: It is the primary cause of tetany. Low ionized calcium levels in the extracellular fluid increase the permeability of neuronal membranes to sodium ions, causing a progressive depolarization, which increases the possibility of action potentials. This occurs because calcium ions interact with the exterior surface of sodium channels in the plasma membrane of nerve cells. When calcium ions are absent the voltage level required to open voltage gated sodium channels is significantly altered (less excitation is required).[1] If the plasma Ca2+ decreases to less than 50% of the normal value of 9.4 mg/dl, action potentials may be spontaneously generated, causing contraction of peripheral skeletal muscles. Hypocalcemia is not a term for tetany but is rather a cause of tetany.


Cow grazing on rapidly grown pasture with tetany of the neck suggesting Grass Tetany[7]

An excess of potassium in grass hay or pasture can trigger winter tetany, or grass tetany, in ruminants.


French Professor Armand Trousseau (1801-1867) devised the trick (now known as the Trousseau sign of latent tetany) of occluding the brachial artery by squeezing, to trigger cramps in the fingers. Also, tetany can be demonstrated by tapping anterior to the ear, at the emergence of the facial nerve. A resultant twitch of the nose or lips suggests low calcium levels. This is now known as the Chvostek sign.

Tetany is characterized by contraction of distal muscles of the hands (carpal spasm with extension of interphalangeal joints and adduction and flexion of the metacarpophalangeal joints) and feet (pedal spasm) and is associated with tingling around the mouth and distally in the limbs.

EMG studies reveal single or often grouped motor unit discharges at low discharge frequency during tetany episodes.


  1. ^ Hall, John, ed. (2010). Guyton and Hall textbook of medical physiology (12th ed.). Philadelphia, Pa.: Saunders/Elsevier. p. 64.  
  2. ^ Haldimann, B.; Vogt, K. (Sep 1983). "[Hyperphosphatemia and tetany following phosphate enema]". Schweiz Med Wochenschr 113 (35): 1231–3.  
  3. ^ Sutters, M.; Gaboury, CL.; Bennett, WM. (Oct 1996). "Severe hyperphosphatemia and hypocalcemia: a dilemma in patient management". J Am Soc Nephrol 7 (10): 2056–61.  
  4. ^ Hall, John, ed. (2010). Guyton and Hall textbook of medical physiology (12th ed.). Philadelphia, Pa.: Saunders/Elsevier. p. 367.  
  5. ^ Hall, John, ed. (2010). Guyton and Hall textbook of medical physiology (12th ed.). Philadelphia, Pa.: Saunders/Elsevier. p. 856.  
  6. ^ Grobin, W (May 14, 1960). "A New Syndrome, Magnesium-Deficiency Tetany". Canadian Medical Association journal 82 (20): 1034–5.  
  7. ^ Bill Kvasnicka, Les J. Krysl. "Grass Tetany in Beef Cattle". Beef Cattle Handbook (PDF). 
  • Harrison's Principles of Internal Medicine 16th Edition - Dennis L. Kasper, Eugene Braunwald, Stephen Hauser, Dan Longo, J. Larry Jameson, Anthony S. Fauci.

Further reading

  • Maccallum, WG; Voegtlin, C (Jan 9, 1909). "On the relation of tetany to the parathyroid glands and to calcium metabolism". The Journal of experimental medicine 11 (1): 118–51.  
  • Williams, A; Abraham, D; Liddle, V (2011). "Tetany: A diagnostic dilemma". Journal of Anaesthesiology, Clinical Pharmacology 27 (3): 393–394.  
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