A post-operative patient 24 hours after total thyroidectomy complains of tingling and numbness around the mouth (perioral paresthesia). Tapping over the facial nerve in front of the ear produces ipsilateral facial muscle twitching. What is this clinical sign?

Answer and explanation

Correct answer: B. Chvostek's sign

  1. Step 1: Total thyroidectomy carries risk of accidental devascularization or removal of the parathyroid glands, leading to acute hypocalcemia.
  2. Step 2: Chvostek's sign is facial muscle spasm elicited by tapping the facial nerve anterior to the external auditory meatus, indicative of neuromuscular hyperexcitability from hypocalcemia.
Answer
Chvostek's sign.
Why not the others: Trousseau's sign is carpal spasm induced by inflating a blood pressure cuff above systolic pressure for 3 minutes; Kernig's and Brudzinski's signs indicate meningeal irritation.

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