Cramps and tingling: A diagnostic conundrum

Abstract

Tetany a syndrome of sharp flexion of the wrist and ankle joints (carpopedal spasm), muscle twitching, cramps and convulsions, sometimes with an attack of stridor, is due to hyperexcitability of nerves and muscles caused by decreased extracellular ionized calcium. Hyperventilation secondary to anxiety can result in tetany. We report a case of hyperventilation induced tetany 2 h following spinal anesthesia for inguinal hernia repair.

The relationship between restless legs syndrome and bronchial asthma

“…In our study, no significant relationship between RLS and polyneuropathy and use of inhaled steroids was found. Another group of drugs that leads to symptoms that could be confused with RLS are β2 agonists, which can cause cramp‐like symptoms by decreasing serum electrolytes . No relationship was detected between β2 agonists and RLS.…”

Spontaneous bilateral carpopedal spasm in a bulimic patient

“…Hypokalaemia is worsened by intracellular shift of potassium due to alkalosis. Tetany can manifest from hypocalcaemia, hypomagnesaemia, hypokalaemia or alkalosis 1. Our patient had all four factors, which greatly increased the neuromuscular irritability and induced spontaneous carpopedal spasm.…”

“…It occurs due to hyperexcitable nerves and muscles in the setting of decreased extracellular ionised calcium 1. Bulimia nervosa, to the extent of causing spontaneous carpopedal spasm, has not been reported in literature.…”

Spectrum of Disorders associated with Tetany

“…Hyperventilation-induced tetany is also prevalent after spinal anesthesia. [24][25][26][27][28] Mechanism of spinal anesthesia-induced hyperventilation is not yet understood properly. High intercostal paralysis/paresis from spinal anesthesia can cause a feeling of suffocation in extremely stressed patients leading to hyperventilation.…”