A positive Chvostek sign is most often associated with which electrolyte abnormality?

• A. Hypocalcemia
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypermagnesemia

Answer: (A)

A positive Chvostek sign reflects increased neuromuscular excitability from low calcium levels in the extracellular fluid. When calcium is low, nerves fire more easily, so tapping the facial nerve elicits twitching of the facial muscles. This classic sign points most often to hypocalcemia, which can occur with conditions like hypoparathyroidism or vitamin D deficiency. Other electrolyte problems don’t typically produce this facial twitch on tapping: high potassium tends to cause weakness and heart rhythm issues, low sodium affects mental status and seizures in severe cases, and high magnesium generally causes reduced reflexes rather than a positive Chvostek sign.