A 45-year-old woman presented with a two-day history of diarrhea, vomiting, progressive numbness around her mouth and generalized body cramps. She had undergone a total thyroidectomy for a multinodular goiter seven months back. Her vital signs were stable. Trousseau sign was evidenced a few seconds after the sphygmomanometer cuff was inflated to more than the systolic blood pressure on the left upper arm. What is the most likely diagnosis? Diagnosis is at the end of the article but first let's answer these questions           what is Trousseau sign?    and what is Chvostek sign? Signs of Hypocalcemia The Chvostek Sign is a clinical sign of existing nerve hyperexcitability (tetany) seen in hypocalcemia. It refers to an abnormal reaction to the stimulation of the facial nerve. When the facial nerve is tapped in front of tragus the facial muscles on the same side of the face will contract momentarily (typically a twitch of the nose or lips) because of hypocalcemia wi