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Clinical features of hypocalcaemia

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The predominant effects of hypocalcaemia are on the nerves and muscles. Typical features include:

  • tetany, painful cramps, and tingling in the extremities
  • latent tetany may be demonstrated by Trousseau's and Chvostek's signs
  • severe tetany may result in spontaneous spasm of the hand - main d'accoucheur - largely precipitated by exercise
  • laryngeal spasm may cause stridor, obstructed respiration
  • convulsions may occur as hypocalcaemia lowers the seizure threshold
  • chronic hypocalcaemia may cause psychiatric effects - from general malaise to overt psychosis

Other features depend on the underlying cause. They are more features of chronic disease and may include:

  • candidosis, dystrophic nails, alopecia, intracranial calcification especially of basal ganglia, cataracts, Addison's disease, mental deficiency, papilloedema, prolonged QT on ECG - from hypoparathyroidism
  • rickets / osteomalacia - from vitamin D deficiency

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