What is the Chvostek sign in patients with hypocalcemia?

Updated: Aug 08, 2019
  • Author: Manish Suneja, MD, FASN, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Dry skin or patches of psoriasis and eczema may be present, particularly in patients with chronic hypocalcemia. Excoriations as a result of pruritus may be noted. Test for Chvostek sign by tapping the skin over the facial nerve about 2 cm anterior to the external auditory meatus. Ipsilateral contraction of the facial muscles is a positive sign. Depending on the calcium level, a graded response will occur: twitching first at the angle of the mouth, then by the nose, the eye, and the facial muscles. Up to 10% of the population will have a positive Chvostek sign in the absence of hypocalcemia; thus, this test, while suggestive, is not diagnostic of hypocalcemia.


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