In my patient, the diagnosis was made when
a trial of hyperventilation reproduced her
symptoms; the presence of a Chvostek’s sign
while normocalcemic supported this interpretation.
In some patients, attacks of hyperventilation-induced
tetany are common
(spasmophilia), and a chronic hyperventilation
syndrome can develop. This is frequently
associated with anxiety, but an underlying
organic etiology can also be the cause.10
The
treatment of this syndrome is often directed
toward identifying and treating the underlying
cause, but at least one small study argues
that carbamazapine may be effective.6