Figure 2. Illustration of a positive Chvostek sign following percussion over the vertical ramus of the mandible.

There are variable techniques used to elicit the Chvostek sign, and the X marks one common location used to elicit the sign, located midway from the ear to the corner of the mouth. The finger is percussing over another common area, the vertical ramus of the mandible. The illustrated Chvostek sign represents what some would grade as a marked sign, as it involves the orbicularis oculi and ala nasi in addition to the orbicularis oris. A mild sign only involves contraction of the orbicularis oris muscle.