Summary
A review of 84 clinical examinations for chronic latent tetany in 19 adult patients is reported. Chvostek’s sign was found an unreliable index of latent tetany, while Trousseau’s sign was much more dependable. Experimental hyperventilation was found approximately as efficient in diagnosis as Trousseau’s sign, although it has the disadvantage that it needs the co-operation of the patient. When Trousseau’s sign is negative, the use of a fourth test which combines both the tourniquet and hyperventilation is described (the combined test).
There is no single reliable bed-side test for chronic latent tetany, but using all four tests only one patient gave completely negative results. His serum calcium was almost normal and he had no symptoms of latent tetany during the preceding six months.
It is suggested that for routine purposes only three tests are needed: (i) Chvostek’s sign; (ii) Trousseau’s sign and, where it is negative, (iii) hyperventilation for approximately 80 seconds, starting immediately after release of tourniquet. This combined test was positive in 16 out of 20 instances and it therefore greatly increases the usefulness of the tourniquet test.
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Bibliography
Graham, S. G. and Andersen, J. H. (1924).Lancet, (1), 1307.
O’Donovan, D. K. (1943).Irish Jo. Med. Sci. p. 519.
O’Donovan, D. K., Boland, S. J., McGrath, J. G., (1942).Lancet, (2), 4.
Additional information
Assisted by a Grant from the Medical Research Council of Ireland.
This work was done at St. Vincent’s Hospital and the Department of Physioloigy U.C.D., where facilities were kindly provided by Prof. J. M. O’Connor and the Medical Research Council of Ireland.
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O’Donovan, D.K. The diagnosis of chronic latent tetany in adults. Ir J Med Sci 20, 146–153 (1945). https://doi.org/10.1007/BF02952337
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DOI: https://doi.org/10.1007/BF02952337