Medical Case Review: Tetany
A 23 year female presented to Emergency with sudden stiffness of hand muscles, tingling sensation in the face with difficulty in opening the jaws and weakness of muscles of thighs for about 2-3 hours.
She had no other complains.
No similar History in tha past.
LMP was 3 months back.
GC- Patient looked anxious
PILCyClOD- Pallor +
- Chest -NAD
- CVS-s1 s2 m0
- P/A- soft, non tender
- Tap on facial nreve= tingling �and twitching ( ? Chvostek)
Knee Jerks: slightly exaggerated.
Our Differentials were:
- 1. Tetany
- 2. Conversion Disorder
Lab Reports revealed:
TC,DC,Urine R/m/e, �all within normal range
Urine pregnancy test- positive
Na+ 132 mEQ/l
Ca++ 6.1 mEQ/l
WHAT COULD BE THE DIAGNOSIS?
Is it likely to see features of tetany at 6.1 meq Ca++?
what is conversion disorder?
It was formerly called hysteria.
It is not intentional as many people think, think misconception should be erased.
As per ICD and DSM:
Conversion disorder is a condition where patients present with neurological symptoms such as numbness, paralysis, or fits, but where no neurological explanation can be found. It is thought that these problems arise in response to difficulties in the patient’s life, and conversion is considered a psychiatric disorder in the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV)