Chvostek Sign of Hypocalcemia and Tetany

Chvostek sign or Chvostek's sign is a clinical sign of hypocalcemia or low calcium level or tetany. It is an abnormal spasm of facial muscles to the stimulation of facial nerve and indicates the nerve hyperexcitability. Twitching of face when the facial nerve is tapped in the area of parotid gland. How Chvostek sign is elicited? For the way of explanation, the area approximately 2 cm in front of earlobe and 1 cm below the zygomatic arch is struck or tapped by a finger or hammer, ipsilateral muscles supplied by facial nerve contract and observed in the form twitching. Twitching occurs especially in tip of nose or lips. Chvostek sign is not a specific or reliable sign of tetany.
Other more reliable sign of hypocalcemia is trousseau sign. When the blood pressure cuff is inflated more than systolic blood pressure and kept for three minutes, it causes spasm of muscles of hand and forearm. In this spasm, wrist and metacarpophalangeal joints flex, proximal interphalangeal joint (PIP) and distal interphalangeal (DIP) joint extend, and the finger adduct.

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