Tetany

Tetany is a muscular condition that affects many people across the world every year. Read on to know what is Tetany, its types, causes, symptoms, diagnosis, treatment and more.

It is a condition that is indicated by symptoms like tremors, spasms and muscular cramps. It may affect any muscle in the human body such as the ones in the calves, face and fingers.

The term “Tetany” like “tetanus”  comes from the Greek word “tetanos” which means Convulsive Tension.

Tetany Image | Source Image Copyright: openi.nlm.nih.gov

Causes of Tetany

This disease is caused by other disorders and conditions that enhance the frequency of action potential. The condition is mainly brought about by a combination of symptoms that occur due to low level of calcium. These can involve

• Carpopedal spasm or spasms of the feet and hands
• Laryngospasm (spasm that affects the larynx, or the voice box)
• Cramps
• Hyperreflexia (hyperactive neurological reflexes)

Tetany is generally believed to be a result of acute hypocalcemia or very low levels of calcium in the bloodstream. It may also arise from a drop in the ionized component of plasma calcium without pronounced Hypocalcemia, as happens in acute alkalosis. Acute alkalosis is a condition in which there is extreme alkalinity in bloodstream.

Although laboratory tests normally measure low level of calcium in blood plasma, the actual cause of Tetany is low level of ionic calcium in fluid between one cell and another or the extracellular fluid or and intracellular fluid or the fluid present within cells.

This condition arises from a metabolic imbalance caused by not only calcium deficiency but also low levels of magnesium and potassium in blood due to over-acidity or over-alkalinity of the human body. It may be associated with Hypophosphatemia, Hypoparathyroidism, Renal disorders, Osteomalacia and other medical syndromes.

The bacterium Clostridium tetani can also cause Tetany as it leads to an acute toxic infection of the CNS (central nervous system).

Tetany Symptoms

It is a condition marked by sensory symptoms that involve paresthesias or odd sensations of the tongue, lips, feet and fingers. In some cases there may be Carpopedal spasms which may be painful and persistent. Other signs of Tetany can include spasms of the facial muscles and generalized muscle pain.

Here is a brief description of Tetany signs in various parts of the body.

Hands

The condition makes the fingers of the hands partly curled or causes them to come together to make a fist. In acute cases, the nails of the fingers may dig deep into the palms of the hands thereby leaving red, painful marks and also resulting in bleeding. Until medical care is provided, it is necessary to wear braces or wrap the fingers and hands to prevent hyperextension.

Feet

The condition makes nerves in the soles of the feet highly sensitive and leads to impaired movement and painful walking. The toes of the feet, similar to fingers of hands, curl involuntarily in the direction of the soles. It may also draw the entire foot into a pointed state. Alternatively, the toes can also get pulled backward in the direction of the shin causing the foot to become arched or flat.

If you have your toes pulled backward, you may wear wearing high-heeled shoes or flexible shoes that allows some mobility. Patients often complain of soreness in the calf muscles following prolonged Tetany of a severe nature in the feet. Wearing braces or wrapping the feet can provide support and help avoid hyper-extension during periods of severe Tetany.

Face and neck

Moderate symptoms of this disorder involve a tingling sensation in the cheeks, tongue and lips. Ticks may also arise in the cheeks and eyelids. There may be pain in the neck. Severe muscular spasms in the jaw for a prolonged time period can lead to cracking or gnashing of the teeth.

You may avoid damage to your teeth by wearing a mouth, especially at night when there is little conscious control. If the condition is acute, neck spasms may lead to symptoms akin to whiplash. However, they reduce with time with little enduring effect. If painful symptoms in the neck do not resolve within a week after the resolution of Tetany, you should contact your healthcare provider.

Arms and legs

If the condition affects the legs and arms, it may lead to sudden jerks in the muscles or uncontrollable impulses to bend your limbs into unnatural positions. The act of bending limbs may be conscious or unconscious. Lying or sitting for a prolonged time period can make you suddenly realize that you have twisted one limb or multiple extremities without experiencing any apparent discomfort. Moderate relief often comes from cramping sensations that originate from twisting the arms behind the back or trapping them at the sides of the body. Patients of this condition often cross their legs beneath the body or between stands of chair.

Tetany Diagnosis

Squeezing the finger can trigger cramps of this disease and lead to a diagnosis. It can also be detected by tapping near the ear at the emerging point of the facial nerve. This is known popularly as Chvostek sign.

Doctors also analyse the medical history of the patient. Blood tests are also conducted to find out whether there is an increase in phosphorus level and a deficiency of Vitamin D and Calcium.

Tetany Treatment

The aim of treatment is to restore the metabsolic balance. This may be done by intravenous administration of calcium as is done in case of Hypocalcemia or Calcium Deficiency. Cure is mainly done in various ways such as prescription drugs, medications and lifestyle modifications. If all other methods of treatment fail to bring about an improvement in the condition of a Tetany patient, surgical operation may be used as a last resort. The method of cure actually depends on the underlying cause of the disorder.

Surgical operation for curing this condition is usually Parathyroidectomy which consists of removal of the parathyroid tumors. Parathyroidectomy is performed to cure hyperparathyroidism, which can often lead to a severe dysfunction of the rest of the parathyroid glands. This may lead to severe Hypoparathyroidism and acute Hypocalcemia that may arise all of a sudden. Sudden, severe hypocalcemia can result in life-endangering Tetany and possibly the blockage of airways. Such cases are infrequent, but require immediate treatment that may be done with the aid of intravenous calcium as well as careful supervision of cardiac function. The status of airways should also be checked.

Treatment for Tetany disease mainly involves calcium replacement. Intravenous calcium is initially administered to patients in order to restore normalcy in calcium levels of patients. Calcium is also administered along with Vitamin D for long-term cure of this condition. This is necessary for calcium absorption into the bones.

Tetany Types

Some of the major types of Tetany are

Hypocalcemic Tetany

It is caused by unusually low calcium level in the bloodstream. Hypocalcemia Tetany is marked by symptoms like excessive sensitivity of the neural and muscular tissues. In an adult woman, Low Calcium Tetany is an early symptom of DiGeorge Syndrome.

Grass Tetany

It is an acute metabolic disease that primarily arises in milk cows. However, all cattle are at risk of having this condition. It is also known as Grass Staggers, Hypomagnesemia and Lactation Tetany.

This disorder results from a drop in the level of magnesium in the bloodstream. The condition usually arises during the grazing of cattle in spring and autumn season. Cows that graze on wheat, oats or young ryegrass in January and December are highly susceptible to having this condition. Grazing in fields where the soil is rich in potassium or magnesium may also give rise to Grass Tetany disease in livestock.

If ignored and left without treatment, the condition may even lead to death.

Latent Tetany Syndrome

It is an unusual disorder marked by periodic tremors and painful spasms in the muscle. The disease often results from Hyperventilation and Limb Ischaemia. It involves various non-specific symptoms such as

• Hand and foot cramps
• Generalized weakness
• Anxiety
• Distal Paresthesia
• Depression

The disease is variously regarded as Chronic Hyperventilation Syndrome and Normocalcaemic Tetany. It is recognised more in Europe than in the United States.

The condition is caused by an unusually low calcium level in the bloodstream. It often leads to Carpopedal spasms. Insufficiency of Parathyroid Hormone Secretion is also a common cause for this disease.

Neonatal Tetany

It refers to a general, persistent muscle Hypertonicity in young infants and newborns. The condition is also known as Tetanism. It is an unusual disease that is marked by occasional tremors and painful spasms in the muscles. It is caused by defective calcium metabolism and related with decreased activity of the parathyroid glands.

Hyperventilation Tetany

It is a Tetany or muscular condition that results from forced respiration resulting from a deficiency of carbon dioxide in bloodstream. It is a nervous condition that is characterized by discomforting symptoms like spasms, cramps and muscular twitches.

Duration Tetany

It is a persistent muscular contraction that arises in response to a strong, constant jerking. It is particularly seen in muscles that have become degenerated.

Gastric Tetany

It is a severe type of Tetany that arises due to stomach disorders. It is characterized by painful spasms in the limbs and difficult breathing.

Parathyroid Tetany

Also known as Parathyroprival Tetany, it occurs due to impaired functioning or removal of the parathyroids.

Tetany, much like other conditions, is best cured when treated at the earliest. If you notice the symptoms of this disease in yourself or your close ones, do not delay treatment. Early cure will help in early recovery and prevention of future complications.