With hypocalcaemia, neuromuscular, neural and cardiovascular abnormalities predominate. Neural hyperexcitability causes smooth and skeletal muscle contractions.

Neural findings include:

• Dementia or overt psychosis
• Irritability
• Confusion
• Hallucinations
• Extrapyramidal manifestations and
• Seizures.

Cardiovascular findings include:

• Bradycardia/tachycardia
• Signs of heart failure
• Prolongation of QT interval
• Refractory hypotension and
• Arrhythmias.