What Is Tetany?
Tetany is a condition where the body experiences severe pain when exposed to certain substances or situations. It is characterized by intense physical symptoms such as: headaches, muscle aches, nausea, vomiting, dizziness and other unusual sensations. These symptoms are often accompanied with extreme fatigue and weakness. People suffering from tetanism may experience these same symptoms on exposure to sunlight or even just touching cold objects such as ice cubes or hot water bottles.
The cause of tetanism is not fully understood, but it is believed that there are several factors involved including chemical imbalances within the body. Some scientists believe that the symptoms are caused by toxins produced by bacteria in the gut. Others think they could be due to a buildup of toxic chemicals called cytokines which affect various parts of the body. Still others have theorized that it might be due to some sort of autoimmune reaction, though this theory has yet to be proven scientifically.
Symptoms of Tetany
While most people experiencing tetanic symptoms will experience them only under specific circumstances, there are many cases where they occur without any warning whatsoever. Symptoms of tetanism vary greatly depending on the person affected. However, if left untreated, symptoms can lead to death. There are no known cures for tetany.
Treatment consists mainly of rest and medications to help alleviate the pain associated with it. Some people suffering from tetany have been known to experience relief or even complete recovery from tetanic symptoms when exposed to very low temperatures.
When exposed to sunlight or other sources of heat, people suffering from tetany can suffer from burns which affect the skin and eyes in the form of blisters and bleeding. When subjected to extreme cold, people can experience frostbite, which can also lead to permanent damage or even death if left untreated. Severe muscle pain caused by tetany can lead to spasms and rigidity of muscles that can cause bones to break or joints to be dislocated. This rigidity causes the person to experience severe pain as the muscles contract involuntarily, which can cause damage to internal organs in the form of ruptured blood vessels and such.
Other symptoms of tetany include extreme nausea and vomiting when exposed to certain foods such as milk, sugar, and other things containing carbohydrates. The person may also experience headaches and bloodshot eyes.
Though tetany can be found in males and females of all ages, it is more commonly found in women than men, most often in women of childbearing years. Most people who are affected by tetany have a family history of the disease.
History of Tetany
The word “tetany” derives from the medical term tetanos, which means “spasm” in ancient Greek. The definition of the word has evolved over time from simply describing a spasm to also describing a type of muscle spasm called tetany, which is caused by low levels of calcium in the blood (hypocalcemia). The name was first used in English in 1656.
The first known descriptions of tetany were made by the ancient Greek physician, Galen. Galen described certain types of muscle spasms that he believed to be caused by an excess of black bile in the body, which he referred to as “tetanos”. In 1757, a century after Galen’s death, a British doctor and professor named Thomas Long provided a more accurate description of tetany.
Long believed that tetany was caused by an excess of nervous energy in the body, which he referred to as “tetanic electricity.” He also believed that the condition had psychological rather than physical causes. Long’s theories continued to be accepted and taught well into the early 1800s.
In 1923, a British physician named Robert Williams described a form of tetany that affected both sides of the body evenly, which he referred to as cerebral tetany. He also found that the condition could be treated with a special diet of milk and eggs.
Physicians began to understand the relationship between tetany and low levels of calcium in the blood in the 1850s, when a German physician named Charles O’Neill discovered that administering large doses of calcium chloride could help prevent and treat the condition.
In 1956, an American physician named John Crile published an article proposing a link between tetany and vitamin C deficiency. Crile’s theory was later confirmed by another physician, Wilfrid Shute.
In 1965, the first mutated gene to be associated with tetany was discovered. The discovery was made by an American doctor and geneticist named Victor A. McKusick.
A second gene that could cause tetany was discovered in 1996.
In 2006, a third gene linked to the condition was discovered.
Tetany Causes and Risk Factors
As of 2011, three genes have been linked to the development of tetany:
GCH1 (gd metabolic acidosis)
MUC1 (multiple cutaneous and mucosal sialodeficiency syndrome)
ABCC6 (uracil-DNA glycosylase gene defect)
Tetany can be inherited or acquired. It is found more often in girls than boys and usually shows up in infancy, childhood, or the teenage years. The three genes that cause tetany are involved in the following processes:
GCH1: the GTP Cyclohydrolase I enzyme helps convert glycogen to glucose for energy. When this enzyme is mutated, excess glycogen and glucose build up in the body.
MUC1: a gene that encodes for a protein involved in cell communication.
ABCC6: codes for a protein that helps protect cells from oxidative stress, among other functions.
Tetany Symptoms and Complications
The following are some possible tetany symptoms:
Excessive muscle tension.
Pain in the muscles (myalgia).
Worsening of symptoms when exposed to warm temperatures (tetany or rigors). This can be very painful.
Altered sensation, such as prickling or tingling (paresthesias).
The symptoms of tetany can resemble other medical conditions or problems. Always see your healthcare provider for a diagnosis.
If your tetany is caused by the GCH1 gene, you may also have the following additional symptoms:
Abnormal teeth that are small, poorly formed, and prone to decay.
Enlarged liver and spleen.
Poorly formed bones that can be short, curved, or irregular.
If your tetany is caused by the MUC1 gene, you may also have the following additional symptoms:
Abnormally short limbs.
Low body temperature.
Bowing of the legs.
If your tetany is caused by the ABCC6 gene, you may also have the following symptoms:
Severely shortened life span.
Non-cancerous overgrowth of skin, cartilage, and bone.
How is Tetany Diagnosed?
A medical professional can diagnose tetany by taking a medical and family history, reviewing potential tetany symptoms, and performing a physical examination. The healthcare provider may also order lab tests to rule out other potential causes of your tetany.
Specific treatment for tetany will be determined by your physician based on:
Your age, overall health, and medical history.
Extent of the disease.
Your tolerance for specific medications, procedures, or therapies.
Expectations for the course of the disease.
Your opinion or preference.
The goal of tetany treatment is to manage the symptoms, which may include:
Managing tetany symptoms and side effects with pain relievers and anticonvulsant drugs.
Surgery to remove or bypass affected areas.
Patient education and support.
What is the Prognosis for Tetany?
The prognosis for tetany is variable. Some people can live a long and normal life with minimal complications, while others may experience developmental delays or other complications.
Ongoing treatment and management may be necessary for life.
Prevention of Tetany
There is no known way to prevent tetany.
Sources & references used in this article:
The magnesium-deficiency tetany syndrome in man by BL Vallee, WEC Wacker, DD Ulmer – New England Journal of …, 1960 – Mass Medical Soc
Grass tetany of ruminants by DL Grunes, PR Stout, JR Brownell – Advances in Agronomy, 1970 – Elsevier
On the relation of tetany to the parathyroid glands and to calcium metabolism by WG MacCallum, C Voegtlin – The Journal of experimental medicine, 1909 – rupress.org
Grass tetany in grazing milking cows. by A Kemp, ML t Hart – Netherlands journal of agricultural science, 1957 – library.wur.nl
Further experimental studies in tetany by WG MacCallum, KM Vogel – The Journal of experimental medicine, 1913 – rupress.org
Spontaneous hypopotassemia, hypomagnesemia, alkalosis and tetany due to hypersecretion of corticosterone-like mineralocorticoid by IJ Mader, LT Iseri – The American Journal of Medicine, 1955 – amjmed.com