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Chvostek's sign - Revision history
2024-03-28T18:53:32Z
Revision history for this page on the wiki
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https://www.wikidoc.org/index.php?title=Chvostek%27s_sign&diff=1104841&oldid=prev
Kiran Singh: /* References */
2015-06-03T01:09:45Z
<p><span dir="auto"><span class="autocomment">References</span></span></p>
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Kiran Singh
https://www.wikidoc.org/index.php?title=Chvostek%27s_sign&diff=1080508&oldid=prev
Gerald Chi at 18:46, 30 March 2015
2015-03-30T18:46:21Z
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 18:46, 30 March 2015</td>
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Gerald Chi
https://www.wikidoc.org/index.php?title=Chvostek%27s_sign&diff=1080507&oldid=prev
Gerald Chi at 18:45, 30 March 2015
2015-03-30T18:45:54Z
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<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"></del></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"></del></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Overview ==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Overview ==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"></del></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>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 [[hypocalcemia]], 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.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>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 [[hypocalcemia]], 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.</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Differential Diagnosis ==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Differential Diagnosis ==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"></del></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>In alphabetical order: <ref>McKennis A, Waddington C, Nursing Interventions for Potential Complications After Thyroidectomy, Continuing Education Featured Article.</ref> <ref>Urbano F.L. Signs of Hypocalcemia: Chvostek' and Trousseau' Signs. Hospital Physician. March 2000. </ref> <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77. </ref></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>In alphabetical order: <ref>McKennis A, Waddington C, Nursing Interventions for Potential Complications After Thyroidectomy, Continuing Education Featured Article.</ref> <ref>Urbano F.L. Signs of Hypocalcemia: Chvostek' and Trousseau' Signs. Hospital Physician. March 2000. </ref> <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77. </ref></div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Physical Examination and Appearance of the Patient== </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Physical Examination and Appearance of the Patient== </div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><gallery></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><gallery></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>image:1.png|Evaluation of Chvostek' Sign: A= The Chvostek I phenomenon and B= The Chvostek II phenomenon</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>image:1.png|Evaluation of Chvostek' Sign: A= The Chvostek I phenomenon and B= The Chvostek II phenomenon</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Laboratory Findings == </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Laboratory Findings == </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"></del></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Hypocalcemia]]</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Hypocalcemia]]</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"></del></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Calcium]] repletion.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Calcium]] repletion.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== References ==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== References ==</div></td></tr>
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== Overview ==<br />
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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 [[hypocalcemia]], 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.<br />
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It was first described by [[František Chvostek]], an Austrian physician in 1876, and later independently by Nathan Weiss in 1883. <br />
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The [[Trousseau sign of latent tetany]] is also often used to detect early tetany.<br />
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Chvostek's Sign seen in tetany and sometimes in anxiety states. <br />
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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]].<br />
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== Differential Diagnosis ==<br />
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In alphabetical order: <ref>McKennis A, Waddington C, Nursing Interventions for Potential Complications After Thyroidectomy, Continuing Education Featured Article.</ref> <ref>Urbano F.L. Signs of Hypocalcemia: Chvostek' and Trousseau' Signs. Hospital Physician. March 2000. </ref> <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77. </ref><br />
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* [[Hyperventilation]] <br />
* [[Hypocalcemia]]<br />
* [[Hypomagnesemia]]<br />
* [[Hypoparathyroidism]]<br />
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== Physical Examination and Appearance of the Patient== <br />
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<gallery><br />
image:1.png|Evaluation of Chvostek' Sign: A= The Chvostek I phenomenon and B= The Chvostek II phenomenon<br />
image:2.png|Appearance of a patient with Chvostek's Sign<br />
</gallery><br />
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== Laboratory Findings == <br />
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[[Hypocalcemia]]<br />
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==Treatment==<br />
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[[Calcium]] repletion.<br />
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== References ==<br />
{{reflist|2}}<br />
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{{WikiDoc Sources}}<br />
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[[Category:Otolaryngology]]<br />
[[Category:Signs and symptoms]]</div>
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