By Linda Hageman, RN
Tetany is described by Steadman’s Medical Dictionary (1), as a clinical neurological syndrome characterized by muscle twitches, cramps, and carpopedal spasm, and when severe laryngospasm and seizures these findings reflect irritability of the central and peripheral nervous system, usually resulting from low serum of ionized calcium or, rarely magnesium. Causes include hyperthyroidism, hyperventilation, rickets, and uremia.
Tetany is considered a medical emergency in which the muscle fibers contract involuntarily and cause painful cramping. These muscle fibers lack enough calcium to the muscles; consequently the muscle fibers are unable to relax, due to low calcium levels in the bloodstream.
People affected with Multiple Endocrine Neoplasia (MEN1), often have their parathyroid glands removed because the parathyroids are releasing too much parathyroid hormone, commonly known as PTH, which regulates the amount of calcium in the blood. If there is an excess of calcium, in the blood, kidney stones can and will often form. Increased PTH causes osteoporosis and weakening of the bones by taking calcium from the bones to keep the serum calcium at an increased rate.
When the parathyroids are completely removed you no longer have PTH regulating the calcium levels in your blood. This calcium must be replaced by a supplemental calcium (possibility TUMS) and a Vitamin D, as calcium cannot be absorbed, by the body, unless you have good levels of Vitamin D. These levels can be easily tested with blood work.
When your body does not have enough calcium the following symptoms can occur:
- Prickling, numbness, burning, or tingling around the mouth, lips, tongue, hands, fingers, and toes.
- Painful involuntary muscle contractions of the muscles which you are unable to relax.
- Abnormal heart rhythms and slowing of the heart.
TETANY IS A SEROUS EMERGENCY MEDICAL CONDITION. IF YOU HAVE INVOLUNTARY MUSCLE CONTRACTIONS CALL 911 FOR EMERGENCY HELP.
Tetany is treated in a medical facility, by a physician who will give Calcium Carbonate through and IV or Central Line. Once the calcium rises you will probably be given a muscle relaxant or tranquilizer and in a matter of minutes your painful muscle contractions will be relieved.
Lab work will include a Calcium Level; a Comprehensive Blood Panel will give the medical personnel information about other abnormalities in the blood. Often the Potassium, Sodium, Phosphorous, Bicarbonate, and Magnesium will be found to be at abnormally low levels, and will have to be replaced, probably through your IV. When you are discharged you may have to continue to take supplements for these abnormally low levels.
Click here to read more information about comparison of commonly used calcium replacement products, submitted by Simon Cai, Pharmacy Candidate, 2016, South College School of Pharmacy.
- Carpopedal: relating to the wrist and the foot or the hands and feel; denoting especially carpopedal spasm. (2)
- Central Line: tube surgically inserted into a vein in the central circulation. Commonly used for long-term IV therapy. (3)
- Central Nervous System: The brain and the spinal cord. (4)
- Peripheral Nervous System: The peripheral part of the nervous system external to the brain and spinal card from their roots to the peripheral terminations. This includes the ganglia, both sensory and autonomic, and any plexuses through which the nerve fibers run. (5)
(1) Steadman’s Medical Dictionary for the Heal Professionals and Nursing, Lippincott Williams & Wilkins, Fifth Edition, 2005, pg. 1453 (2) pg. 241; (3) pg. 255; (4) pg. 254; (5) pg. 1110