THE SYMPTOMS of irritation in an attack of tetany in adult man consist of tingling, which begins in the face and hands, and, somewhat later, a feeling of tension and spasm in the face and the small muscles of the hand. If the attack is aggravated, the tingling and spasm spread from the hand proximally along the arm. Immediately afterward the same symptoms begin to manifest themselves peripherally in the legs, spreading proximally and finally reaching the trunk. In addition, fascicular twitches in muscles, bordering on spasm, irregularly occur. It was previously shown1 that these symptoms of irritation studied in the arm were caused by spontaneous discharges first and foremost in the proximal part of the longest nerve fibers. The activity starts in the tactile fibers, from which the typical sensation of tingling originates, and, somewhat later, is set up in other afferent fibers, producing a feeling of tension.
KUGELBERG E. ACTIVATION OF HUMAN NERVES BY HYPERVENTILATION AND HYPOCALCEMIANeurologic Mechanism of Symptoms of Irritation in Tetany. Arch NeurPsych. 1948;60(2):153-164. doi:10.1001/archneurpsyc.1948.02310020049004