Carpo pedal syndrome

Definition:
A spasm of the feet and hand observed in hyperventilation, calcium deprivation, tetany.

-Associated with tetany
-Lowered muscular excitability threshold
-Results in involuntary spasms
-Diffuse muscles involved in severe, spontaneous tetany
-Laryngeal Stridor (noisy breathing, crow like)
-Generalized Tonic Clonic Seizure (seizure involving the entire body. It is also called a grand mal seizure. Such seizures usually involve muscle rigidity, violent muscle contractions, and loss of consciousness)
-Death may occur

Causes
-Hyperventilation
-Hypoparathyroidism
-Hypocalcemia
-Hypomagnesemia

Pathophysiology of hyperventilation
-Triggered by fear, anxiety, stress or pain.
-Involves increasingly rapid breathing.
-Respiratory rate ↑, CO2 level ↓ resulting in alkalosis.
-Causes left shift of oxyhemoglobin disassociation curve in which the hemoglobin hold on tightly to O2 and does not unload them effectively.
-Results in hypoxia and anxiety.
-Carpopedal spasm is a characteristic sign of respiratory alkolosis.
-Involves tingling and contraction of hands and feet due to hypocapnia (↓ level of CO2).

Indications of carpopedal spasm
Trousseau’s sign
-Technique
Occlusion of brachial artery with BP cuff for 3 minutes

-Interpretation: Positive test suggests Carpopedal Spasm Carpal Spasm symptoms elicited

Chvostek’s sign
-A sign of tetany seen in hypocalcemia.
-Tap facial nerve at the angle of jaw (masseter muscle) , facial muscles on the same side will contract momentarily.
-This is due to hypocalcaemia, with hyperexcitability of the nerves