Tetanus is a subject that affects all of us. Nowadays, despite medical advances, it can still be dangerous. What do we really know about this disease? What are the symptoms of tetany and how can you protect yourself against it? Learn not only about the medical aspects of tetany, but also about practical tips for prevention.
What is tetany?
Tetany is a condition of excessive neuromuscular excitability that manifests as muscle tremors and painful spasms. People experiencing this condition often also experience unpleasant tingling in the muscles, known as paresthesias. It is worth noting that tetany is not classified as a stand-alone condition, but rather as a set of symptoms that can accompany a variety of conditions or result from electrolyte imbalances in the body. It is associated with a reduced concentration of calcium or magnesium in the blood, which leads to an increase in the rate of transmission of nerve impulses to the muscles and thus their excessive excitability. Tetany can affect people of any age. However, it is most commonly reported in young, active adults. There are two main types of tetany: overt tetany and latent tetany, which differ in intensity and nature of symptoms.
Overt tetanus
A type of tetany in which the symptoms are clearly noticeable and often very distressing. It is characterised by intense muscle spasms that can involve both limbs and facial muscles. Sufferers of overt tetany experience severe tremor, pain and a feeling of tension in the muscles. In addition, it is often accompanied by paresthesias, or tingling or burning sensations in various parts of the body. These symptoms can occur suddenly and be triggered by stress, changes in diet or excessive physical exertion. Overt tetany not only affects the comfort of everyday life, but can also lead to more serious health consequences. Especially if it is not diagnosed and treated properly. Therefore, it is important for people experiencing these symptoms to consult a doctor in order to identify the causes and implement appropriate therapeutic measures.
Latent tetany
This is the less obvious type, in which the symptoms are more subtle and may not be immediately noticeable. Unlike overt tetany, the muscle spasms in this form are less intense and patients may only experience general weakness, tingling or slight tension in the muscles. Symptoms may occur sporadically and are often confused with other complaints, making it difficult to make a correct diagnosis. Latent tetany can be triggered by electrolyte deficiencies, stress or hormonal changes, and its course can be unpredictable. Although it may seem less bothersome, it requires attention because, if left untreated, it can lead to an exacerbation of symptoms and more serious health problems. Therefore, it is important for those who suspect latent tetany to see a specialist who can help identify the causes and plan appropriate treatment.
Causes of tetany
As already mentioned, tetany is the result of disturbances in the calcium-phosphate balance. The most common causes are reduced calcium levels in the blood (hypocalcaemia) and low magnesium levels (hypomagnesaemia). Such disorders can be caused by various hormonal problems and loss of electrolytes from the body, such as:
- post-operative hypoparathyroidism
- idiopathic hypoparathyroidism
- chronic conditions of the digestive system, e.g. coeliac disease or diarrhoea
- hypothyroidism
- use of diuretics
- alcoholism
- effects of radiotherapy in the neck (parathyroid damage)
- diseases that lead to a decrease in serum calcium, such as acute pancreatitis
- debilitating diseases, including cancer
- significant vitamin D deficiency
- poor diet, low in calcium and magnesium
Parathormone, a hormone secreted by the parathyroid glands, plays an important role in regulating calcium levels. When its concentration falls, parathormone increases calcium absorption in the gastrointestinal tract, promotes calcium reabsorption in the kidneys and releases calcium stores from the bones, leading to an increase in blood calcium levels. When the parathyroid glands do not function properly (hypoparathyroidism), parathormone production is insufficient, leading to a further decrease in serum calcium levels.
What are the most common symptoms of tetany?
Tetany is a set of symptoms that are associated with disturbances in neuromuscular conduction. Initially, there is usually a feeling of numbness and tingling, especially around the mouth and fingertips. Painful muscle spasms are also among the typical symptoms. In the case of overt tetany, a characteristic phenomenon called 'obstetrician's hand' can often be observed, consisting of straightening of the thumb, index and middle finger, while the fourth and fifth fingers remain bent. In addition, visual disturbances, photophobia, headaches, chest discomfort, palpitations, fainting, as well as convulsions, flatulence or muscle stiffness. In latent tetany, on the other hand, patients often complain of neurological symptoms such as memory problems, difficulty concentrating, insomnia, general malaise, chronic fatigueirritability and anxiety.
Symptoms of tetany vs. treatment
We treat the symptoms of tetany primarily by supplementing blood calcium levels. In this way, we can prevent acute symptoms and potential complications. In the case of simultaneous magnesium and potassium deficiencies, appropriate supplements are used. Many people with tetany are also vitamin D deficient, so supplementation is recommended, especially during autumn and winter. In patients whose symptoms are caused by hypoparathyroidism, long-term oral calcium and vitamin D preparations are often necessary. Magnesium supplements and psychological support from specialists are effective in the treatment of latent tetany.
It is also worth introducing a balanced diet rich in calcium and magnesium. Calcium can be found in foods such as leafy vegetables, legumes and powdered milk. In addition, cheeses (e.g. bryndza, gouda, Edam cheese), nuts, beetroot, cocoa and coarse cereals. These products have a favourable calcium/phosphorus ratio, which favours their absorption. People with tetany should avoid highly processed foods and fizzy drinks such as cola, which are high in phosphates, which hinders calcium absorption. Conversely, good sources of magnesium include leafy vegetables, cereal sprouts, whole-grain cereal products, legumes, bananas, maize and nuts.
