[Video] Trousseau sign

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Trousseau's sign occurs in patients with hypocalcaemia and results from enhanced neuromuscular excitability. This sign is named after Armand Trousseau (1801-1867) a French physician who was also the first to perform a tracheotomy in France.

This should not to be confused with his other discovery: Trousseau's sign of malignancy or Trousseau's syndrome (migratory thrombophlebitis from underlying pancreatic, lung, colon, or gastric carcinoma).

How to perform this test:
  • Inform the patient about the procedure as it is very uncomfortable and painful
  • A blood pressure cuff is inflated to a pressure above the patients systolic level or you can do it by using your both hands to compress at patient's cubital area.
  • This pressure has to be continued for several minutes
  • Look for carpopedal spasm which involves the following:
  1. flexion at the wrist
  2. flexion at the metacarpophalangeal joints
  3. extension of the interphalangeal joints
  4. adduction of the thumbs and fingers
  • The posture of the hand has been described as "Main d'accoucheur" meaning obstetricians hand
  • Patients may also experience paraesthesia of the fingers and there may be muscle fasciculations
Sensitivity and specificity of this sign
Trousseau's sign is said to occur before the other signs of hypocalcaemia e.g. hyperreflexia. It is both specific and sensitive for hypocalcaemia. However, it is less sensitive than Chvostek's sign (tapping on the facial nerve).

This sign may also occur in hypomagnesaemia.



via patient.co.uk


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