Knowledge (XXG)

Chvostek sign

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119:, an Austrian-born surgeon who lived in Moravia, in the Czech Republic. In his professional life, Chvostek devoted himself to the study of etiopathogenesis and to the treatment of neurological disorders, including by means of electrotherapy. In 1876, he first described the sign that bears his name. Later it was independently described by another Austrian physician, 183:
It can also be found in subjects with respiratory alkalosis, for example as a result of hyperventilation syndrome, which can lead to a drastic reduction of the concentration in serum of calcium ions while at normal levels, for the binding of a significant proportion of ionized calcium (Ca) with
200:. The sensitivity is lower than that in the corresponding Trousseau sign as it is negative in 30% of patients with hypocalcemia. Due to the combination of poor sensitivity and specificity the clinical utility of this sign is reduced. 78:
These facial spasms are caused by the nerves that control the muscle being easily excited (called hyperexcitability) due to hypocalcemia. Hypocalcemia can be caused by many things, including parathyroid conditions (such as when the
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supplying the area is occluded. The Trousseau sign of latent tetany also generally occurs earlier than the Chvostek sign and is a more accurate predictor of hypocalcemia, allowing clinicians to recognise the condition earlier.
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in front of the ear, the facial muscles on the same side of the face will contract sporadically (called ipsilateral facial spasm). The muscles that control the nose, lips and eyebrows are often the ones that will spasm.
827: 140:. Response occurs in the form of ipsilateral contraction of some or all of the muscles innervated by the facial nerve. The effect is the lateral deviation of the labial and nasal fold toward the stimulated side. 148:
Hitting a point between the middle third and upper third of the line joining the angle of the mouth to the zygomatic process gives rise to only a contraction of the muscles of the mouth and nose.
546: 91:). Sometimes, the Chvostek sign can be caused by other conditions which interfere with the balance of calcium, such as imbalanced acid and alkaline in blood causing 136:
It is obtained by striking with a finger or a hammer a point that is approximately 2 cm in front of the lobe of the ear and about 1 cm below the
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Garrad, P; Perks, AM (Aug 1990). "The effects of temperature change on lung liquid production by in vitro lungs from fetal guinea pigs".
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sign of tetany as it may be seen in 10% to 25% of healthy adults. It is therefore not a reliable clinical sign for diagnosing latent
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Jesus, JE; Landry, A (Sep 13, 2012). "Images in clinical medicine. Chvostek's and Trousseau's signs".
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or diuretics, because hypomagnesemia can cause hypocalcemia. It is also seen in measles, tetanus and
88: 169: 563: 84: 66:). The Chvostek sign is the abnormal twitching of muscles that are activated (innervated) by the 705: 494: 459: 432: 397: 344: 317: 282: 233: 165: 137: 80: 710: 621: 486: 477:
Fonseca, OA; Calverley, JR (Aug 1967). "Neurological manifestations of hypoparathyroidism".
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is another sign of decreased calcium in blood where muscles in the hand contract when the
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Krogh, L; Wynne, JM; Cywes, S (Aug 17, 1968). "The value of Chvostek's sign in tetany".
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activation. It is frequently seen in alcoholics, persons with diarrhea, patients taking
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that someone may have a low blood calcium level (a decreased serum calcium, called
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Weisinger, JR; Bellorín-Font, E (Aug 1, 1998). "Magnesium and phosphorus".
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Flink, EB (1981). "Magnesium deficiency. Etiology and clinical spectrum".
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Goljan, EF. Rapid Review Pathology. Mosby, Elsevier, 2007; pp. 504.
70:(also known as Cranial Nerve Seven, or CNVII). When the facial nerve is 769: 197: 157: 528: 415:
Hoffman, E (Jul 1958). "The Chvostek sign; a clinical study".
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Symptoms and signs: Endocrinology, nutrition, and metabolism
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Wien Med Press 1876;17:1201-3, 1225–27, 1253–58, 1313–16.
47: 50: 41: 32: 44: 35: 768: 719: 696: 673: 650: 562: 29: 374:Méneret, A; Guey, S; Degos, B (Mar 12, 2013). 369: 367: 540: 8: 547: 533: 525: 391: 263:Weiss N. Centralbl Gesammt Ther 1883;1:9. 16:Clinical sign of low blood calcium level 208: 337:Acta Medica Scandinavica. Supplementum 160:. However, it may also be present in 7: 642:Familial hypocalciuric hypercalcemia 491:10.1001/archinte.1967.00300020074009 758:Hypokalemic sensory overstimulation 452:Journal of Developmental Physiology 218:The New England Journal of Medicine 87:) and vitamin diseases (such as a 14: 25: 734:Hyperkalemic periodic paralysis 602:Disorders of calcium metabolism 100:Trousseau sign of latent tetany 83:does not function well, called 805:Cerebral salt-wasting syndrome 753:Hypokalemic periodic paralysis 192:Chvostek's sign is not a very 164:. Magnesium is a cofactor for 1: 479:Archives of Internal Medicine 314:10.1016/S0140-6736(97)10535-9 429:10.1016/0002-9610(58)90868-7 393:10.1212/WNL.0b013e31828728bc 156:Chvostek's sign is found in 607:Hypercalcemia of malignancy 417:American Journal of Surgery 844: 95:(an alkaline blood pH). 636:Dystrophic calcification 632:Metastatic calcification 115:The sign is named after 184:albumin and globulins. 144:Chvostek sign – type II 556:Electrolyte imbalances 230:10.1056/NEJMicm1110569 132:Chvostek sign – type I 123:(1851–1883), in 1883. 275:South African Medical 188:Clinical significance 93:respiratory alkalosis 597:Milk-alkali syndrome 252:Beitrag zur Tetanie. 89:vitamin D deficiency 581:Symptoms and signs 170:parathyroid hormone 515:František Chvostek 117:František Chvostek 85:hypoparathyroidism 815: 814: 166:adenylate cyclase 138:zygomatic process 81:parathyroid gland 835: 622:Calcinosis cutis 549: 542: 535: 526: 503: 502: 474: 468: 467: 447: 441: 440: 412: 406: 405: 395: 371: 362: 359: 353: 352: 332: 326: 325: 297: 291: 290: 270: 264: 261: 255: 248: 242: 241: 213: 57: 56: 53: 52: 49: 46: 43: 40: 37: 34: 31: 843: 842: 838: 837: 836: 834: 833: 832: 818: 817: 816: 811: 764: 715: 692: 669: 646: 558: 553: 511: 506: 476: 475: 471: 449: 448: 444: 414: 413: 409: 373: 372: 365: 360: 356: 334: 333: 329: 308:(9125): 391–6. 299: 298: 294: 272: 271: 267: 262: 258: 249: 245: 215: 214: 210: 206: 190: 174:aminoglycosides 154: 146: 134: 129: 113: 104:brachial artery 28: 24: 17: 12: 11: 5: 841: 839: 831: 830: 820: 819: 813: 812: 810: 809: 808: 807: 802: 797: 787: 786: 785: 783:Salt poisoning 774: 772: 766: 765: 763: 762: 761: 760: 755: 745: 744: 743: 742: 741: 725: 723: 717: 716: 714: 713: 708: 702: 700: 694: 693: 691: 690: 685: 679: 677: 671: 670: 668: 667: 662: 656: 654: 648: 647: 645: 644: 639: 625: 611: 610: 609: 599: 594: 593: 592: 590:Trousseau sign 587: 579: 574: 568: 566: 560: 559: 554: 552: 551: 544: 537: 529: 523: 522: 517: 510: 509:External links 507: 505: 504: 469: 442: 407: 363: 354: 327: 292: 265: 256: 243: 207: 205: 202: 189: 186: 162:hypomagnesemia 153: 150: 145: 142: 133: 130: 128: 125: 112: 109: 15: 13: 10: 9: 6: 4: 3: 2: 840: 829: 826: 825: 823: 806: 803: 801: 798: 796: 793: 792: 791: 788: 784: 781: 780: 779: 776: 775: 773: 771: 767: 759: 756: 754: 751: 750: 749: 746: 740: 737: 736: 735: 732: 731: 730: 727: 726: 724: 722: 718: 712: 709: 707: 704: 703: 701: 699: 695: 689: 686: 684: 681: 680: 678: 676: 672: 666: 663: 661: 658: 657: 655: 653: 649: 643: 640: 637: 633: 629: 628:Calcification 626: 623: 619: 618:Calciphylaxis 615: 612: 608: 605: 604: 603: 600: 598: 595: 591: 588: 586: 585:Chvostek sign 583: 582: 580: 578: 575: 573: 570: 569: 567: 565: 561: 557: 550: 545: 543: 538: 536: 531: 530: 527: 521: 518: 516: 513: 512: 508: 500: 496: 492: 488: 484: 480: 473: 470: 465: 461: 458:(2): 109–14. 457: 453: 446: 443: 438: 434: 430: 426: 422: 418: 411: 408: 403: 399: 394: 389: 385: 381: 377: 370: 368: 364: 358: 355: 350: 346: 342: 338: 331: 328: 323: 319: 315: 311: 307: 303: 296: 293: 288: 284: 281:(32): 846–7. 280: 276: 269: 266: 260: 257: 253: 247: 244: 239: 235: 231: 227: 223: 219: 212: 209: 203: 201: 199: 195: 187: 185: 181: 179: 175: 171: 167: 163: 159: 151: 149: 143: 141: 139: 131: 126: 124: 122: 118: 110: 108: 105: 101: 96: 94: 90: 86: 82: 76: 73: 69: 65: 61: 60:clinical sign 55: 22: 21:Chvostek sign 584: 520:Nathan Weiss 485:(2): 202–6. 482: 478: 472: 455: 451: 445: 420: 416: 410: 386:(11): 1067. 383: 379: 357: 340: 336: 330: 305: 301: 295: 278: 274: 268: 259: 251: 250:Chvostek F. 246: 221: 217: 211: 191: 182: 155: 147: 135: 121:Nathan Weiss 114: 97: 77: 68:facial nerve 64:hypocalcemia 20: 18: 423:(1): 33–7. 224:(11): e15. 614:Calcinosis 343:: 125–37. 204:References 795:Hypotonic 721:Potassium 698:Phosphate 675:Magnesium 380:Neurology 111:Etymology 822:Category 800:Isotonic 652:Chloride 437:13545482 402:23479466 238:22970971 194:specific 178:myxedema 127:Features 564:Calcium 499:4952674 464:2092052 349:7020347 322:9717944 287:5680230 58:) is a 770:Sodium 739:equine 497:  462:  435:  400:  347:  320:  302:Lancet 285:  236:  198:tetany 158:tetany 152:Causes 72:tapped 778:High 729:High 706:High 683:High 660:High 572:High 495:PMID 460:PMID 433:PMID 398:PMID 345:PMID 318:PMID 283:PMID 234:PMID 98:The 19:The 790:Low 748:Low 711:Low 688:Low 665:Low 577:Low 487:doi 483:120 425:doi 388:doi 341:647 310:doi 306:352 226:doi 222:367 824:: 634:, 620:, 493:. 481:. 456:14 454:. 431:. 421:96 419:. 396:. 384:80 382:. 378:. 366:^ 339:. 316:. 304:. 279:42 277:. 232:. 220:. 180:. 638:) 630:( 624:) 616:( 548:e 541:t 534:v 501:. 489:: 466:. 439:. 427:: 404:. 390:: 351:. 324:. 312:: 289:. 240:. 228:: 54:/ 51:k 48:ɪ 45:t 42:s 39:ɒ 36:v 33:k 30:ˈ 27:/ 23:(

Index

/ˈkvɒstɪk/
clinical sign
hypocalcemia
facial nerve
tapped
parathyroid gland
hypoparathyroidism
vitamin D deficiency
respiratory alkalosis
Trousseau sign of latent tetany
brachial artery
František Chvostek
Nathan Weiss
zygomatic process
tetany
hypomagnesemia
adenylate cyclase
parathyroid hormone
aminoglycosides
myxedema
specific
tetany
doi
10.1056/NEJMicm1110569
PMID
22970971
PMID
5680230
doi
10.1016/S0140-6736(97)10535-9

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