In neonates, hypocalcemia is more likely to occur in infants born of diabetic or preeclamptic mothers. Hypocalcemia also may occur in infants born to mothers with hyperparathyroidism.  Clinically evident hypocalcemia generally presents in milder forms and is usually the result of a chronic disease state. In emergency department patients, chronic or subacute complaints secondary to mild or moderate hypocalcemia are more likely to be a chief complaint than severe symptomatic hypocalcemia.  In an elderly patient, a nutritional deficiency may be associated with a low intake of vitamin D. A history of alcoholism can help diagnose hypocalcemia due to magnesium deficiency, malabsorption, or chronic pancreatitis.  Acute hypocalcemia may lead to syncope, congestive heart failure, and angina due to the multiple cardiovascular effects. Neuromuscular and neurologic symptoms may also occur.

Neuromuscular symptoms include the following:
Numbness and tingling sensations in the perioral area or in the fingers and toes
Muscle cramps, particularly in the back and lower extremities
Wheezing; may develop from bronchospasm
Dysphagia
Voice changes (due to laryngospasm)

Neurologic symptoms of hypocalcemia include the following:
Irritability, impaired intellectual capacity, and personality changes
Fatigue
Seizures (eg, grand mal, petit mal, focal)
Other uncontrolled movements

Chronic hypocalcemia may produce the following dermatologic manifestations:
Coarse hair
Brittle nails
Psoriasis
Dry skin
Chronic pruritus
Poor dentition
Cataracts