What is tetany? Symptoms, causes and treatment

Tetany treatment
Medically reviewed by Dr. Sohail Cheema

Key takeaways

  1. Tetany is a medical condition that leads to painful involuntary muscle contractions and painful cramping in the body. Symptoms will be numbness, shortness of breath, and sensory disturbances.
  2. Causes of tetany include disturbances in electrolyte concentration and balance, especially calcium and magnesium, which can lead to involuntary and painful muscle contractions. 
  3. Treatment options start with the correct diagnosis for the underlying condition and treating it with supplemental care. if the tetany is caused by kidney disease, treatment may include managing the kidney disease to help normalize calcium and magnesium levels. If genetic disorders cause tetany, treatment may involve genetic counseling and management of symptoms.

Tetany is a medical condition that leads to painful muscle contractions. It typically begins in the jaw and then progresses to the rest of the body. It is caused by the changes in the electrolyte distribution in the body. 
Disturbances in electrolyte concentration, especially calcium and magnesium, can lead to involuntary muscle contractions termed Tetany. Common symptoms include Numbness around the mouth and shortness of breath, while some serious common symptoms include Painful muscle cramps, loss of vision, and paralysis.  

Treatment options start with the correct diagnosis for the underlying condition and treating it with supplemental care.

What is tetany?

Tetany is a medical condition consisting of the involuntary contraction of muscles that leads to painful muscle cramps, larynx, and sensory disturbances. It is caused by low blood calcium levels or electrolyte imbalance in the body. High magnesium or calcium supplements can reduce the occurrence of Tetany.

It is a disorder with a highly variable clinical presentation. It includes enhanced neuromuscular activity and associated sensory disturbance. These spasms occur due to a sudden decrease in calcium levels in the blood, which is essential for proper muscle function. The condition can affect any muscle in the body, but it typically affects the hands, feet, and face.

Mild symptoms may include circumoral numbness, muscle cramps, or paresthesias of hands and feet. In severe cases, patients may present with laryngospasm, generalized muscle cramps, seizures, or even myocardial dysfunction.

The increased excitability of the peripheral nerves is due to either low serum calcium levels or alkalosis (excess alkali in the body).

Types of tetany

Latent (spasmophilia)

It is caused by intracellular magnesium deficiency and increased respiratory drive. The muscle spasms can be painful and affect the hands, feet, face, and neck. Other symptoms of latent Tetany may include numbness and tingling in the hands and feet, anxiety, and irritability.

Manifest Tetany

Manifest Tetany refers to a more severe form of Tetany in which the symptoms are more pronounced and may include muscle cramps, spasms, and contractions, as well as tremors, muscle twitching and weakness. The symptoms include numbness around the mouth and prickling of the hands and feet.

Symptoms of Tetany

Some common mild symptoms of Tetany include:

  • Numbness around the mouth 
  • Muscle cramps 
  • Paresthesia (burning sensation in the hands and feet)
  • Shortness of breath

Some severe symptoms of Tetany include:

  • Laryngospasms can cause difficulty breathing.
  • Bronchospasms (when the muscles lining your lungs’ airways tighten).
  • Painful muscle cramps.
  • Vomiting
  • Loss of vision 
  • Paralysis 
  • Tetany seizures
  • A cardiac function, such as an irregular heart rhythm (arrhythmia).

While Tetany is often not life-threatening, it can sometimes lead to rhabdomyolysis, a condition that causes muscle breakdown or death.

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What are the most common causes of tetany?

Tetany is typically brought on by an electrolyte imbalance, frequently many ones. When they dissolve in water, electrolyte chemicals acquire a natural positive or negative electrical charge.

Since your body comprises 60 percent water, electrolytes are present in almost all your body’s fluids and cells. They assist your body in some ways, including regulating chemical processes and preserving fluid equilibrium inside and outside your cells. Your muscles contract because your cells employ electrolytes to carry electrical charges.

The cause of Tetany often involves a combination of metabolic abnormalities rather than a single cause. Following are some of them

1. Hypocalcemia

Tetany often results from low blood calcium levels, a common reason. A lack of calcium can cause uncontrollable muscle spasms since calcium is essential for muscle contraction. Vitamin D insufficiency, renal illness, hypoparathyroidism, and malabsorption syndromes are a few of the causes of hypocalcemia.

2. Hypomagnesemia

It happens due to low magnesium levels in the blood. Magnesium is an important electrolyte that is a vital part of many body functions. Chronic disease, heavy alcohol intake, gastrointestinal issues, kidney issues, and other conditions can cause hypomagnesemia.

3. Hypokalemia

It happens due to low potassium levels in your blood. Potassium is an electrolyte crucial for adequately functioning nerves, muscle cells, and the heart. Common causes of hypokalemia include diuretics, vomiting, diarrhea, and chronic kidney disease.

4. Alkalosis

An increase in blood pH can also cause tetany. Alkalosis can occur due to several factors, including hyperventilation or ingestion of alkaline substances.

5. Respiratory alkalosis/ Hyperventilation

this happens when you breathe too fast or deep, causing your lungs to get rid of too much carbon dioxide. It can decrease the carbon dioxide levels in the blood, which then becomes alkaline. Hyperventilation due to stress or anxiety can also lead to Tetany.

6. Certain medications

Some medications, such as diuretics (hydrochlorothiazide (HCTZ), chlorthalidone, and indapamide) or phenytoin, can interfere with calcium levels in the body. These medications, by acting in the body, can cause reabsorption of calcium, leading to calcium level balance.

7. Other conditions

Tetany can also occur due to other medical conditions, such as kidney disease, liver disease and vitamin D deficiency. Additionally, certain genetic disorders can cause tetanus, such as hyperekplexia or familial hypocalciuric hypercalcemia.

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How is tetany treated?

Consulting a healthcare provider will help diagnose the condition at the right time for the right diagnosis as well as treatment, Treatment options will be according to the underlying medical condition.

1. For hypocalcemia

If low blood calcium levels result in tetany, treatment options include vitamin D supplementation and calcium. Patients can take calcium supplements orally, whereas vitamin D supplements can be given as ergocalciferol or cholecalciferol. In cases of severe hypocalcemia, intravenous calcium may be necessary. In addition to accessories, the underlying cause of hypocalcemia should be treated. For instance, controlling renal illness may be required if it is the underlying cause of hypocalcemia to assist in normalizing calcium levels.

2. For hypomagnesemia

If low magnesium levels in the blood cause tetany, treatment may involve magnesium supplementation. Patients can take magnesium supplements orally or intravenously in severe cases. If malabsorption syndromes cause hypomagnesemia, treatment may include addressing the underlying condition causing malabsorption.

3. In case of hyperventilation

Tetany brought on by hyperventilation may be treated with breathing exercises or relaxation methods to calm the patient and avoid rapid breathing. Slow, deep, pursed-lip breathing and belly breathing are other helpful techniques. Counseling or therapy may also aid in stress management and stop excessive breathing.

4. For Hypoparathyroidism

If hypoparathyroidism is the cause of tetany, treatment may involve hormone replacement therapy with calcium and vitamin D supplements. The goal of treatment is to maintain normal calcium levels in the blood. Regular monitoring of calcium levels and adjustment of medication dosages may be necessary.

5. Alkalosis Treatment

If alkalosis causes tetany, treatment may involve correcting the pH of the blood by addressing the underlying cause. For example, if the alkalosis is caused by hyperventilation, treatment may include managing rapid breathing to prevent further alkalosis. Medications that help restore normal pH levels may sometimes be necessary.

6. Other Conditions and their treatment options

If another medical condition causes tetany, treatment may involve addressing the underlying condition. 

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For example, if the tetany is caused by kidney disease, treatment may include managing the kidney disease to help normalize calcium and magnesium levels.

If genetic disorders cause tetany, treatment may involve genetic counseling and management of symptoms.

What is the difference between tetany and clonus?

Tetany and Clonus are both medical conditions related to muscle contractions. They differ regarding causation agent, nature of presenting symptoms, and contractions. 

Disturbances in electrolytes cause tetany, while clonus is caused by neurological conditions that affect the upper motor neurons.

Tetany can lead to a wide range of symptoms, including muscle spasms and tingling, while Clonus is characterized by the specific manifestation of rapid, repetitive muscle contractions in response to an outer stimulus.

Who is most likely to get tetany?

Tetany can occur in individuals of any age, gender, or race. However, specific populations may be more susceptible to tetany than others due to various risk factors.

  • People with medical conditions affecting calcium metabolism, such as chronic kidney disease, hypoparathyroidism, or malabsorption syndromes, are at higher risk of tetany due to hypocalcemia.
  • Individuals who have undergone thyroid or parathyroid surgery may also be at risk of developing tetany, as the surgery can affect calcium regulation in the body.
  • Individuals with a history of malnutrition or following a restrictive diet that lacks essential nutrients, including calcium and magnesium, may also be at risk of developing tetany due to nutritional deficiencies.
  • People undergoing treatments that affect calcium levels, such as chemotherapy or radiation therapy, may risk developing hypocalcemia and tetany.
  • People who experience hyperventilation due to anxiety or panic attacks may also be at risk of developing tetany due to respiratory alkalosis, which can cause a decrease in blood calcium levels.
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How can tetany be diagnosed?

The diagnosis of tetany typically involves a combination of clinical evaluation, medical history assessment, and laboratory tests. Here’s an overview of the diagnostic process for tetany:

1. Medical history and physical examination 

A detailed history, including any symptoms you have been experiencing. A physical examination to assess muscle strength, reflexes (Chvostek and Trousseau signs), and any visible signs of muscle spasms or cramps.

2. Blood tests

Laboratory tests are crucial in diagnosing tetany. Blood samples will be taken to measure various parameters, including calcium, magnesium, phosphate, and parathyroid hormone (PTH) levels. Low calcium levels are a crucial feature of tetany. The total calcium level may be measured, but the ionized calcium level is a more accurate reflection of calcium status in the body.

3. Electrocardiogram (ECG)

An ECG may be performed to assess the heart’s electrical activity. Low calcium levels can affect heart function and may result in abnormal ECG findings.

4. Urine tests

It is collected to measure calcium and other electrolyte levels. This helps determine whether there is excessive calcium loss through the urine, which can contribute to hypocalcemia.

5. Additional tests

In some cases, further tests may be required to identify the underlying cause of tetany. These tests may include thyroid function tests, renal function tests, or genetic testing to assess for conditions such as hypoparathyroidism or other disorders affecting calcium metabolism.

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How can tetany be prevented?

Depending on the various reasons, the following steps can help prevent tetany:

1. Balanced diet

Tetany brought on by mineral deficiencies can be avoided with a balanced diet that includes foods high in calcium, magnesium, and other necessary elements. Tetany can be avoided by consuming fruits, vegetables, complete grains, lean meats, and healthy fats.

2. Supplements

Tetany brought on by nutritional deficits can be avoided by taking calcium and magnesium supplements. However, a healthcare practitioner should be consulted before taking any supplements, as consuming too many of these minerals can be dangerous.

3. Sunlight exposure

Spending time in the sun can help the body produce vitamin D, which is essential for calcium absorption and can help prevent the development of tetany caused by hypocalcemia.

4. Managing underlying medical conditions

Managing underlying medical conditions such as kidney disease, hypoparathyroidism, or malabsorption syndromes can help prevent the development of tetany.

5. Managing stress and anxiety

Hyperventilation brought on by stress and anxiety can result in alkalosis and tetany. Deep breathing, meditation, and yoga are all relaxing practices that can reduce stress and stop the onset of tetany.

6. Avoiding alkaline substances

Avoid ingesting alkaline substances such as antacids can help prevent the development of alkalosis and tetany.

Complications caused by tetany

Because Tetany can be due to a severe condition, not seeking treatment can lead to serious complications and permanent damage.

Once your healthcare provider has identified the underlying cause, you must follow the treatment plan your healthcare provider explicitly designed to reduce the risk of potential complications. Such complications may include the following:

  • Respiratory distress: Tetany can cause respiratory distress, as muscle spasms and contractions can interfere with normal breathing.
  • Cardiac arrhythmias: Low calcium levels in the blood can lead to heart rhythm disturbances, which can be severe and life-threatening.
  • Seizures: Tetany can cause seizures, which are sudden, uncontrolled electrical discharges in the brain.
  • Coma: Tetany can cause unconsciousness in severe cases, leading to coma.
  • Pneumonia: Tetany can cause swallowing difficulties, increasing the risk of pneumonia and other respiratory infections.
  • Bone fractures: Tetany can cause weakness and muscle wasting, increasing the risk of fractures and other orthopedic problems.

When to Consult a Doctor?

Ignoring that tetany is a serious complication and may lead to other medical complications is an injustice to your health. It is recommended to consult a doctor as soon as possible to get the disease treated. 

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FAQs About Tetany Answered By Your Doctor Online Team

Is Tetany a seizure?

Tetany and seizures are two different conditions. A seizure is an uncontrolled burst of electrical activity in your brain that can cause behavioral and movement changes. In comparison, Tetany involves involuntary muscle contractions.

How do low calcium levels cause tetany?

Patients may receive calcium or magnesium supplements intravenously or orally to alleviate tetany from low blood levels of these minerals. In extreme circumstances, intravenous calcium gluconate may quickly raise blood calcium levels. Depending on the underlying reason, other medications may also be used to treat tetany, such as hormone replacement therapy in hypoparathyroidism or medications to balance acid-base in situations of alkalosis.

At Your Doctors Online, we are committed to providing high-quality and trustworthy healthcare information to our users. To ensure the accuracy and reliability of our content, we follow strict sourcing guidelines and rely on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references and prioritize primary sources of information. We understand the importance of providing up-to-date and evidence-based healthcare information to our users, and our editorial policy reflects this commitment.

  • MacCallum, William G., and Carl Voegtlin. “On the relation of tetany to the parathyroid glands and to calcium metabolism.” The Journal of Experimental Medicine 11.1 (1909): 118-151.
  • Martens, Holger, and Monika Schweigel. “Pathophysiology of grass tetany and other hypomagnesemias: implications for clinical management.” Veterinary clinics of North America: Food animal practice 16.2 (2000): 339-368.
  • Vallee, Bert L., Warren EC Wacker, and David D. Ulmer. “The magnesium-deficiency tetany syndrome in man.” New England Journal of Medicine 262.4 (1960): 155-161.
  • Littledike, E. T., J. W. Young, and D. C. Beitz. “Common metabolic diseases of cattle: ketosis, milk fever, grass tetany, and downer cow complex.” Journal of Dairy Science 64.6 (1981): 1465-1482.

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