What is Chvostek’s Sign?

Chvostek’s sign is a part of nursing practice to check for low calcium (hypocalcemia). It’s one of the most common hypocalcemia tests, and it involves tapping on the cheekbone and observing whether you can get a muscle contraction in response.

Similar to Trousseau’s sign, a positive result can indicate a possible hypocalcemia-related health condition. As a nurse, you can use both in patient assessments. The main difference between the two tests is that Chvostek’s is performed on the skin (specifically the face), and Trousseau’s is performed on the arm.

Nurses need to know how to assess Chvostek’s sign because of hypocalcemia, which can point to serious health conditions (such as parathyroid disorders).

What is Chvostek’s Sign?

Chvostek’s sign is the name given to a clinical finding associated with hypocalcemia (low levels of calcium in the blood). It appears as a twitch of the facial muscles following gentle tapping over the facial nerve in front of the ear.

With hypocalcemia, neurons are less stable and more likely to fire spontaneously, leading to a condition called tetany (the involuntary contraction of muscles).

Hypocalcemia Causes

• Vitamin D deficiency
• Parathyroid disorders (such as Hypoparathyroidism)
• Parathyroid gland surgery
• Thyroidectomy (thyroid removal surgery)
• Family history 
• Kidney failure 
• Hypomagnesemia
• Pancreatitis

Learn more about electrolytes lab values (including hypocalcemia) here.

Chvostek’s vs Trousseau’s Sign

Chvostek’s and Trousseau’s signs are both indicators of low calcium, but they manifest differently.

Chvostek’s sign is seen in the face when facial muscles twitch after the facial nerve is tapped lightly on the upper cheek, (just in front of the ear). This is caused by increased neuromuscular excitability.

On the other hand, Trousseau’s sign occurs with the contraction of the muscles in the hand and wrist (i.e., carpopedal spasm). This is seen after you put a blood pressure cuff on a client.

How is the Chvostek Sign is Performed

The Chvostek sign is performed by tapping gently on the cheek two centimeters in front of the ear, over the facial nerve (also known as CN VII).

Positive Chvostek’s Sign

When a patient twitches their facial muscles in response to tapping over the area of the facial nerve, you can say that they have a positive Chvostek’s sign. 

Negative Chvostek’s Sign

Your client has a negative Chvostek’s sign when their facial muscles don’t contract, even when stimulating them with a tapping motion.

Learn Nursing Concepts in Less Time

Chvostek’s sign is a type of patient assessment for checking low calcium. Similar to Trousseau’s sign, a positive result can indicate a possible underlying health condition. Knowing the ins and outs of nursing assessments (including Chvostek’s) and their results is crucial to nursing learning and practice.

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