Which signs are classic for postoperative hypocalcemia?

• A. Chvostek and Trousseau signs are positive.
• B. Kernig sign.
• C. Romberg test.
• D. Bradykinesia.

Answer: (A)

Postoperative hypocalcemia causes neuromuscular hyperexcitability, leading to tetany and tingling as calcium levels drop after parathyroid or neck surgery. The classic bedside clues are Chvostek sign and Trousseau sign. Chvostek sign occurs when tapping the face in front of the ear triggers twitching of facial muscles, reflecting facial nerve–muscle irritability from low calcium. Trousseau sign is demonstrated by inflating a blood pressure cuff above systolic pressure for a few minutes, which induces carpal spasm and a characteristic flexion of the fingers and wrist—another direct sign of hypocalcemia. These signs are emblematic of the condition and point clinicians toward calcium replacement if the patient is symptomatic.

Kernig sign, Romberg test, and bradykinesia reflect other conditions—meningeal irritation, balance/proprioception issues, and movement disorder symptoms, respectively—not the calcium-related neuromuscular irritability seen after neck surgery.