Tetany: Symptoms, Causes, Treatment, Cost, and Side Effects

Tetany is a symptom which is brought on by an uncontrollable muscle spasm or cramp that can be caused due to the imbalance of electrolytes, especially calcium, in the body. The spasms can also be brought on by an excess of phosphate in ratio to calcium. It can cause anything from minor arm or leg cramps to serious alterations such as interfering with the heart muscles.

Tetany often does not pose a life-threatening risk, although in severe cases it might become fatal. Rhabdomyolysis, a potentially fatal illness caused by muscle loss and breakdown, can occasionally result from severe occurrences of tetany. Although there are successful therapies for tetany, preventing it frequently depends on identifying the original cause.

Clinical signs of tetany can range from minor sensory abnormalities to serious, life-threatening problems. Numbness around the lips, uncomfortable muscle cramps, and paresthesias (burning or tingling sensation of the hands and feet) are examples of its mild symptoms. Laryngospasm, or voice box spasms, which can make breathing challenging and cause high-pitched sounds during breathing (laryngeal stridor), may be present in people with severe cases. Tetany patients may also have convulsions, generalized muscle cramps, vomiting, and impaired cardiac function, including an irregular heartbeat. When a muscle tightens uncontrollably and is unable to release, it develops a cramp, which causes excruciating pain.

An indication of tetany is the presence of overstimulated peripheral nerves and involuntary muscular spasms. Tetany can have many symptoms ranging from mild to severe.

Here are some of typical, minor tetany symptoms, that may include;

• Numbness in the mouth area
• Muscles cramping
• Feeling tingly or hot in your feet and hands (paresthesia)

Tetany's severe symptoms include;

• Laryngospasm, or voice box spasms, which can make breathing difficult
• Bronchospasms (when the muscles that lining the airways in your lungs tighten)
• Excruciating, radiating muscular spasms
• Vomiting
• Seizures
• Reduced cardiac performance, such as an erratic heartbeat (arrhythmia)

Consult an expert team of doctors at Pristyn care if you experience any tetany symptoms, even if they are slight.

Tetany is typically brought on by an electrolyte imbalance. Electrolytes are chemicals that take on a natural positive or negative electrical charge when dissolved in water.

As water constitutes around 60% of our body, meaning that electrolytes are present in almost all of our bodily fluids and cells. They assist our body in a number of ways, including regulating chemical processes, preserving fluid equilibrium inside and outside of your cells, and more. Your muscles contract because your cells employ electrolytes to carry electrical charges.

When the amounts of calcium in your blood are too low, you have hypocalcemia. It is the most frequent reason for tetany. Your blood contains calcium, which supports healthy neuron function, tightening of the muscles, blood clotting in the event of bleeding, and heart function. Although hypocalcemia can be brought on by a variety of medical disorders, it's frequently brought on by low levels of vitamin D or the underactive parathyroid gland, a condition known as hypoparathyroidism.

Tetany can result from many electrolyte abnormalities, including:

• Hypocalcemia: When the amounts of calcium in your blood are too low, you have hypocalcemia. It is the most frequent reason for tetany. Your blood contains calcium, which supports healthy neuron function, tightening of the muscles, blood clotting in the event of bleeding, and heart function. Although hypocalcemia can be brought on by a variety of medical disorders, it's frequently brought on by low levels of vitamin D or the parathyroid hormone that also causes hypoparathyroidism. In the case of hypoparathyroidism, the body's production of parathyroid hormone is inadequate. This may result in sharply decreased calcium levels, which may cause tetany.
• Hypomagnesemia: When the level of magnesium in your blood is too low, you have hypomagnesemia. Magnesium is a vital electrolyte and an integral component of numerous body processes. Hypomagnesemia can be brought on by long-term illness, alcoholism, gastrointestinal problems, kidney problems, and other diseases.
• Hypokalemia: When the levels of potassium in your blood are too low, you have hypokalemia. For the proper functioning of your nerve and muscle cells, particularly those in the heart, potassium is a necessary electrolyte. Hypokalemia can be brought on by diuretics, chronic kidney disease, vomiting, and diarrhea.
• Metabolic alkalosis: Alkalosis occurs when your body fluids—such as your blood—contain too many bases or alkalis. Your health depends on the pH (acid-base) level of your blood. You could become ill if the balance is off, even just a little. Your body fluids contain an excessive amount of bicarbonate when you have metabolic alkalosis. It may happen under a number of circumstances.
• Respiratory alkalosis: When you breathe too quickly or deeply, your lungs expel too much carbon dioxide, resulting in respiratory alkalosis. Your blood becomes more alkaline as a result of this decrease in blood carbon dioxide levels. Tetany can be brought on by anxiety-induced hyperventilation.

If you have a condition that causes an electrolyte imbalance, you might not be able to prevent tetany, but as with most medical issues, early detection and treatment can significantly improve your symptoms.

It's crucial to consult your healthcare professional if you're exhibiting early symptoms of tetany, such as numbness around your mouth and muscular spasms. Early electrolyte imbalance treatment can help avoid more severe and possibly fatal tetany symptoms.

• To prevent tetany that is caused by the imbalance of electrolytes, always eat balanced and nutritional food items.
• Lead a healthy and active lifestyle to help the absorption of nutrients in your body that will make an equilibrium of minerals in your body.

• Stay away from diuretics as they can flush out the minerals from your body, hence causing further decrease in electrolytes.
• Too much water can further complicate the condition hence drink it with synthetic electrolytes or go for a glass of juice to replenish yourself with more minerals.

Note, these aforementioned tips can only be helpful for acute tetany patients for patients whose tetany is linked to a chronic illness such as kidney problem or pancreatic issue, a medical help will be needed.

Tetany is frequently suspected in people who experience muscle cramps, burning sensation in their hands and feet, and oral numbness. By evaluating a person's sensory and motor abilities during a full neurological examination, these symptoms can be identified. Tetany symptoms may not always be as obvious in some people, making a diagnosis difficult to make without a high degree of clinical accuracy. Other clinical symptoms, such Trousseau's sign, may occasionally be a marker of hypocalcemia-related tetany.

In order to diagnose tetany, low blood calcium levels are typically required as a marker. Additionally, a person's blood levels of vitamin D, magnesium, phosphorus, and parathyroid hormone (PTH), as well as vitamin D, may help determine the underlying cause of their tetany.

Chvostek and Trousseau signs are two provocative tests for diagnosis of latent tetany. Many diseases including endocrine disorders like hypoparathyroidism and alkalosis by hyperventilation can cause tetany. Infusion of calcium or magnesium is effective as an acute therapy for tetany.

Trousseau: This technique for inducing fingers cramps for the diagnosis of latent tetany was devised by French professor Armand Trousseau, by squeezing the brachial artery, the major blood artery of the arm, as a result blocking its blood pressure. In persons without obvious hypocalcemia symptoms, Trousseau's signs are used to confirm latent tetany.

Chvostek: Touching the area where the facial nerve emerges, anterior to the ear, can show tetany. Resulting contraction of the ipsilateral facial muscles is a clinical sign of hypocalcemia or other electrolyte imbalances and is considered as one of the symptoms of Chvostek. Low calcium levels are indicated by a resulting twitch of the lips or nostrils. A test positive for Chvostek can be considered as a tell away sign for latent tetany.

Investigation of the symptoms in tetany is typically part of the diagnosis process. The doctor could advise a blood test to confirm the diagnosis and evaluate the levels of calcium, magnesium, potassium, and serum electrolytes.

Serum electrolytes consist of:

• Sodium (Na): It is a positively charged electrolyte that supports neuromuscular function and aids in fluid equilibrium inside the body.
• Potassium (K): It is an essential element of cellular fluid and a positive electrolyte that aids in controlling osmotic pressure and neuromuscular activity.
• Calcium (Ca): A positive electrolyte, calcium (Ca) influences neuromuscular function and aids in bone formation and blood clotting.
• Magnesium (Mg): It affects intracellular activity and muscular contractions.
• Chloride (CI): A negative electrolyte, called chloride (CI) controls blood pressure.
• Negative electrolyte phosphate (HPO4): It affects metabolism and controls calcium levels and acid-base equilibrium.
• Bicarbonate (HCO3): It is a negatively charged electrolyte that helps to control the pH levels in the blood. Acid-base diseases are brought on by bicarbonate deficiencies and elevations.

The concentration of some electrolytes in the body might change due to medications, chronic conditions, and trauma that may cause an electrolyte imbalance.

If you're looking for symptoms to confirm tetany, look out for muscle contractions that may twitch, tremor, cramp, spasm because of electrolyte imbalance that would be brought up by hypocalcemia.

Tetany can exhibit following symptoms along with cramps, spasms, or tremors;

• Cramps or soreness in the stomach
• Diarrhea that persists over time
• Grimacing, feeling drained or lazy
• Muscular soreness or pains
• Numbness around your mouth
• Breathing quickly or having trouble breathing
• Tingling or other strange feelings in the hands or feet
• Shaking or twitching of the fingers

As low calcium levels are a primary cause of electrolyte imbalance, that causes tetany, consuming meals high in calcium and magnesium may be beneficial to manage the condition.

Here are some food items that can replenish you with the low levels of electrolytes, hence treating tetany;

• Cheese
• Fortified products
• Milk, including soy milk
• Orange juice
• Salmon
• Sardines
• Spinach
• Tofu
• Yogurt

Tetany that develops as a result of an underlying illness might not be curable. But by making sure you have enough calcium and vitamin D in your diet, you might be able to avoid hypocalcemia.

Tatany is a medial sign of involuntary muscle spasm, twitching, tremors, cramps due to electrolyte imbalance (low levels of ions), low level of calcium in the blood (hypocalcaemia), high levels of phosphate, low levels of carbon dioxide, underfunction of the parathyroid gland are some of the many factors of an underlying condition that can lead to tetany. If any of the aforementioned reasons are treated or managed naturally by your body, tetany can go away on its own. Several therapies and dietary supplements can also help manage tetany.

Tetany that develops as a result of an underlying illness such as hypoparathyroidism, kidney failure or disease of pancreas might not be curable.

As hypocalcemia (low calcium), hypomagnesemia (low magnesium), hypokalemia (low potassium), and low levels of many other natural substances can cause tetany, getting enough calcium, potassium, magnesium in your diet, can help you avoid tetany. Nutritional adjustments may be advised if the disorder is brought on by a poor diet or incorrect fluid intake.

Here are some excellent food sources of calcium;

• Cheese
• Fortified products
• Milk, including soy milk
• Orange juice
• Salmon
• Sardines
• Spinach
• Tofu
• Yogurt

Magnesium

• Avocado
• Banana
• Dark Chocolate
• Fatty fish
• Leafy greens
• Legumes
• Nuts
• Seeds
• Tofu
• Whole grain

Potassium

• Avocado
• Apricots
• Bananas
• Beans
• Beet greens
• Broccoli
• Cantaloupe
• Dried fruits
• Grapefruit
• Honeydew
• Lentils
• Oranges
• Potatoes
• Spinach

High phosphate level to calcium ratio is also known to be one of the many causes of tetany. If you think your prescribed diuretics have caused the electrolyte imbalance you can discontinue it and also all the caffeine based drinks. By avoiding food items high in phosphate you can manage tetany brought on up high phosphate blood levels;

• Asparagus
• Caffeine
• Celery
• Chicken
• Eggs
• Fish
• Mushrooms
• Mutton
• Onions
• Peppers
• Radishes
• Tomatoes

The underlying cause of the issue and the type of electrolyte implicated will determine how electrolyte abnormalities are treated. Electrolyte depletion can be reversed by fluid and electrolyte replacement therapy administered intravenously or orally. Treatment of tetany heavily relies on what is causing the symptoms in the first place. The recommended course of treatment for tetany for calcium depletion is intravenous calcium supplementation. The elemental calcium is given at a dose of 100 to 200 mg in combination with vitamin D since it facilitates calcium absorption in the body. Magnesium supplements are needed when tetany is brought on by a magnesium shortage.

To lower serum potassium levels in hyperkalemic patients with poor renal function, hemodialysis therapy may be necessary. Additionally, it might be advised for renal patients with severe hypermagnesemia.

Involuntary muscular spasms and excessively activated peripheral nerves are symptoms of tetany. Electrolyte imbalances, most frequently low blood calcium levels, are the cause. Tetany can range from exhibiting mild to severe symptoms. As the condition is brought up due to electrolyte imbalance, it can potentially cause arrhythmias (irregular heart beat), rhabdomyolysis (breakdown of muscle tissue, causing renal damage), acute pancreatitis (due to hypocalcemia), shortness of breath among other conditions that can be fatal and needs an urgent care if the symptoms are severe.

If you are suffering from tetany, it's crucial to speak with your healthcare professional. Serious instances necessitate emergency medical attention. The condition can result in respiratory obstruction if you experience severe tetanus-induced (tetanic) muscle spasms, resulting in death.

If you experience symptoms of tetany, you should immediately consult any general physician or neurologist to evaluate the cause of your problem and accordingly treat them with the help of concerned health experts.

You can also reach out to the team of expert doctors at Pristyn care for the diagnosis, management and treatment of your health condition.

In most cases, when the cause of the tetany is known, doctors generally administer concerned chemical compound such as in case of hypocalcemia, calcium supplementation, in case of hypomagnesemia, magnesium while for hypokalemia, potassium is intravenously (IV) given to the patient to treat severe tetany.

During calcium repletion, it's crucial to monitor magnesium levels because a lack of magnesium frequently results in hypocalcemia that is resistant to therapy.

The treatment of tetany requires the accurate diagnosis of its underlying cause. One problem is that a healthcare professional can plan an effective course of action, such as in case of low levels of calcium, calcium will be intravenously administered to the patients in combination with vitamin D for better absorption. Similarly, in case of magnesium deficiency, magnesium will be given and so on.

In case of serious health issues such as chronic kidney disease and pancreatic disease, symptoms of tetany are incurable as of now.

There is no surgical treatment available to treat tetany as it isn’t a neurological condition but is brought on due to imbalance of electrolytes in the body causing seizures, tremors, twitching, cramps and muscle spasm in mild to moderate cases.

Mild tetany symptoms can be managed well with the right diagnosis and effective medication and nutritional diet.

Tetany treatment in India, is very simple, affordable, and cost-effective with a high success rate.

For mild to moderate tetany symptoms, doctors often manage it with the supplements that may be given to you till your concerned electrolyte levels are normalized. However, in case of any severe disease you might need lifelong medicinal help.

Acute tetany can be treated with several supplements that are given orally or intravenously. And once the levels are normal you won’t see any symptom but with recurring electrolyte imbalance the symptoms may again emerge.

• Keep yourself hydrated.
• Do not have caffeine or any diuretic if your symptoms were brought on by depletion of electrolytes.
• Consume a nutritional and balanced diet.
• Maintain a healthy lifestyle to avoid poor absorption of nutritions.

• Diarrhea
• Extreme fatigue
• Muscle cramps
• Numbness or tingling
• Vomiting
• Signs of dehydration
• Unexplained confusion

Tetany itself is not a disease but a cluster of symptoms that shows up when due to any underlying disease electrolyte imbalance happens that leads to sensory abnormalities, painful muscles cramps, spasm, twitching, in extreme cases tremors or even seizures that can be sometimes fatal. Tetany, although can sometimes manifest with other metabolic abnormalities, is typically linked to low blood calcium levels, or hypocalcemia.

It's best to take an expert's help if you experience tetany symptoms and do not self-diagnose or self-treat the condition as accurate diagnosis and cause of tetany is very important to be assessed in order to provide the right treatment.