Trousseau sign of latent tetany
Trousseau sign of latent tetany is a medical sign observed in patients with hypocalcemia. It is named after the French physician Armand Trousseau, who first described it. The sign is elicited by inflating a sphygmomanometer cuff above the patient's systolic blood pressure for several minutes. This action occludes the brachial artery and induces ischemia in the distal tissues, leading to muscle contractions.
Clinical Significance
The Trousseau sign is an important clinical indicator of latent tetany, which is a condition characterized by increased neuromuscular excitability due to low levels of calcium in the blood. It is often used in conjunction with other tests, such as the Chvostek sign, to diagnose hypocalcemia.
Procedure
To elicit the Trousseau sign, the following steps are typically followed:
- The patient's arm is positioned comfortably, and a sphygmomanometer cuff is placed around the upper arm.
- The cuff is inflated to a pressure above the patient's systolic blood pressure and maintained for 3-5 minutes.
- The examiner observes the patient's hand and fingers for signs of carpopedal spasm, which is a characteristic involuntary contraction of the muscles.
Interpretation
A positive Trousseau sign is indicated by the occurrence of carpopedal spasm, which manifests as flexion at the wrist and metacarpophalangeal joints, extension of the interphalangeal joints, and adduction of the thumb. This response suggests the presence of hypocalcemia and warrants further investigation and management.
Associated Conditions
The Trousseau sign is commonly associated with conditions that cause hypocalcemia, including:
History
The sign is named after Armand Trousseau, a 19th-century French physician who made significant contributions to the field of medicine. Trousseau's work in identifying the relationship between hypocalcemia and neuromuscular excitability has had a lasting impact on clinical practice.
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