Difference between revisions of "Chvostek's sign"

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The '''Chvostek's sign''' (also '''Weiss sign''') is one of the [[sign (medicine)|signs]] of [[tetany (medical sign)|tetany]] seen in [[hypocalcemia]]. It refers to an abnormal reaction to the stimulation of the [[facial nerve]]. When the [[facial nerve]] is tapped at the angle of the jaw, the facial muscles on the same side of the face will contract momentarily (typically a twitch of the nose or lips) because of [[hypocalcaemia]] (ie from hypoparathyroidism, pseudohypoparathyroidism, hypovitaminosis D) with resultant hyperexcitability of nerves. Though classically described in hypocalcaemia, this sign may also be encountered in [[respiratory alkalosis]], such as that seen in [[hyperventilation]], which actually causes decreased serum Ca++ with a normal calcium level due to a shift of Ca++ from the blood to [[albumin]] which has become more negative in the alkalotic state.
 
The '''Chvostek's sign''' (also '''Weiss sign''') is one of the [[sign (medicine)|signs]] of [[tetany (medical sign)|tetany]] seen in [[hypocalcemia]]. It refers to an abnormal reaction to the stimulation of the [[facial nerve]]. When the [[facial nerve]] is tapped at the angle of the jaw, the facial muscles on the same side of the face will contract momentarily (typically a twitch of the nose or lips) because of [[hypocalcaemia]] (ie from hypoparathyroidism, pseudohypoparathyroidism, hypovitaminosis D) with resultant hyperexcitability of nerves. Though classically described in hypocalcaemia, this sign may also be encountered in [[respiratory alkalosis]], such as that seen in [[hyperventilation]], which actually causes decreased serum Ca++ with a normal calcium level due to a shift of Ca++ from the blood to [[albumin]] which has become more negative in the alkalotic state.
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==Etymology==
  
 
It was first described by [[František Chvostek]], an Austrian physician in 1876, and later independently by Nathan Weiss in 1883.   
 
It was first described by [[František Chvostek]], an Austrian physician in 1876, and later independently by Nathan Weiss in 1883.   
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Chvostek's Sign seen in tetany and sometimes in anxiety states.  
 
Chvostek's Sign seen in tetany and sometimes in anxiety states.  
  
In modern medical era, the utility of Chvostek's sign has diminished with the development of serum calcium level assessments. However, the sign may still be helpful as crude determinations of the neuromuscular excitability that occurs in patients with hypocalcemia.
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In modern medical era, the utility of Chvostek's sign has diminished with the development of serum calcium level assessments. However, the sign may still be helpful as crude determinations of the neuromuscular excitability that occurs in patients with [[hypocalcemia]].
  
 
== Differential Diagnosis ==
 
== Differential Diagnosis ==

Revision as of 21:29, 22 September 2008

Chvostek's sign
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Overview

The Chvostek's sign (also Weiss sign) is one of the signs of tetany seen in hypocalcemia. It refers to an abnormal reaction to the stimulation of the facial nerve. When the facial nerve is tapped at the angle of the jaw, the facial muscles on the same side of the face will contract momentarily (typically a twitch of the nose or lips) because of hypocalcaemia (ie from hypoparathyroidism, pseudohypoparathyroidism, hypovitaminosis D) with resultant hyperexcitability of nerves. Though classically described in hypocalcaemia, this sign may also be encountered in respiratory alkalosis, such as that seen in hyperventilation, which actually causes decreased serum Ca++ with a normal calcium level due to a shift of Ca++ from the blood to albumin which has become more negative in the alkalotic state.

Etymology

It was first described by František Chvostek, an Austrian physician in 1876, and later independently by Nathan Weiss in 1883.

The Trousseau sign of latent tetany is also often used to detect early tetany.

Chvostek's Sign seen in tetany and sometimes in anxiety states.

In modern medical era, the utility of Chvostek's sign has diminished with the development of serum calcium level assessments. However, the sign may still be helpful as crude determinations of the neuromuscular excitability that occurs in patients with hypocalcemia.

Differential Diagnosis

In alphabetical order: [1] [2] [3]

Physical Examination and Appearance of the Patient

Laboratory Findings

Hypocalcemia

Treatment

Calcium repletion.

References

  1. McKennis A, Waddington C, Nursing Interventions for Potential Complications After Thyroidectomy, Continuing Education Featured Article.
  2. Urbano F.L. Signs of Hypocalcemia: Chvostek' and Trousseau' Signs. Hospital Physician. March 2000.
  3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77.


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| group5 = Clinical Trials Involving Chvostek's sign | list5 = Ongoing Trials on Chvostek's sign at Clinical Trials.govTrial results on Chvostek's signClinical Trials on Chvostek's sign at Google


| group6 = Guidelines / Policies / Government Resources (FDA/CDC) Regarding Chvostek's sign | list6 = US National Guidelines Clearinghouse on Chvostek's signNICE Guidance on Chvostek's signNHS PRODIGY GuidanceFDA on Chvostek's signCDC on Chvostek's sign


| group7 = Textbook Information on Chvostek's sign | list7 = Books and Textbook Information on Chvostek's sign


| group8 = Pharmacology Resources on Chvostek's sign | list8 = AND (Dose)}} Dosing of Chvostek's signAND (drug interactions)}} Drug interactions with Chvostek's signAND (side effects)}} Side effects of Chvostek's signAND (Allergy)}} Allergic reactions to Chvostek's signAND (overdose)}} Overdose information on Chvostek's signAND (carcinogenicity)}} Carcinogenicity information on Chvostek's signAND (pregnancy)}} Chvostek's sign in pregnancyAND (pharmacokinetics)}} Pharmacokinetics of Chvostek's sign


| group9 = Genetics, Pharmacogenomics, and Proteinomics of Chvostek's sign | list9 = AND (pharmacogenomics)}} Genetics of Chvostek's signAND (pharmacogenomics)}} Pharmacogenomics of Chvostek's signAND (proteomics)}} Proteomics of Chvostek's sign


| group10 = Newstories on Chvostek's sign | list10 = Chvostek's sign in the newsBe alerted to news on Chvostek's signNews trends on Chvostek's sign


| group11 = Commentary on Chvostek's sign | list11 = Blogs on Chvostek's sign

| group12 = Patient Resources on Chvostek's sign | list12 = Patient resources on Chvostek's signDiscussion groups on Chvostek's signPatient Handouts on Chvostek's signDirections to Hospitals Treating Chvostek's signRisk calculators and risk factors for Chvostek's sign


| group13 = Healthcare Provider Resources on Chvostek's sign | list13 = Symptoms of Chvostek's signCauses & Risk Factors for Chvostek's signDiagnostic studies for Chvostek's signTreatment of Chvostek's sign

| group14 = Continuing Medical Education (CME) Programs on Chvostek's sign | list14 = CME Programs on Chvostek's sign

| group15 = International Resources on Chvostek's sign | list15 = Chvostek's sign en EspanolChvostek's sign en Francais

| group16 = Business Resources on Chvostek's sign | list16 = Chvostek's sign in the MarketplacePatents on Chvostek's sign

| group17 = Informatics Resources on Chvostek's sign | list17 = List of terms related to Chvostek's sign


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