Which sign indicates hypocalcemia after thyroidectomy?

• A. Bradycardia
• B. Flaccid paralysis
• C. Negative Chvostek's sign
• D. Tingling around the mouth

Answer: (D)

When calcium levels drop after thyroidectomy, nerves become more easily excitable because calcium helps stabilize nerve membranes. The earliest and most telling symptom is tingling around the mouth, a perioral numbness that reflects these heightened nerve irritability changes. This sign appears before more severe manifestations and directly points to low calcium.

Bradycardia can occur with significant hypocalcemia but isn’t as specific or as early a indicator. Flaccid paralysis isn’t the typical neuromuscular response to hypocalcemia in this context, and a negative Chvostek’s sign would argue against hypocalcemia since a positive Chvostek’s sign (facial contraction when tapping the face) is a classic test for it. So tingling around the mouth best signals hypocalcemia after thyroidectomy.