Clinical Manifestations and Pathology

Tetany, characterized by neuromuscular irritability, is often signaled by a tingling sensation in the fingers, and it may become impossible to open and close the hands. Carpopedal spasms (of the wrist and ankle joints) are common, as are stiffness, pain, and spasms in other muscles. Vomiting is also common. Infants in particular may develop a rigid face, "carpmouth," and body - all symptoms that mimic neonatal tetanus. Mental symptoms include hallucinations, dullness, and distortion. Cardiac spasms may develop, and coma, along with respiratory failure (following asthma-like attacks), leads to death. Mortality from neonatal tetany is low today in developed countries because of treatment with calcium. However, in the 1950s and previously, it has been suggested that over half of the victims died. Necropsy findings of hyperplasia of parathyroid glands are confined to children fed cow's milk.

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