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Neurological Manifestations of Hypoparathyroidism

Neurological Manifestations of Hypoparathyroidism Abstract WHEN tetany occurs in a patient soon after surgery on the thyroid or parathyroid glands, hypocalcemia is immediately suspected. However, the diagnosis of hypoparathyroidism is not always so obvious, and many such patients have neurological symptoms such as seizures, increased intracranial pressure, or chorea as the primary manifestations of their hypocalcemia. Major reviews of this subject fail to stress this point.1,2 This report was prompted by the recent study of two patients who presented with neurologic symptoms and later proved to have hypoparathyroidism. These two cases will be reported in detail, and the neurological manifestations in 40 additional patients with hypoparathyroidism seen at this institution since 1944 will be presented. Material and Methods The records of all patients discharged from The University of Texas Medical Branch Hospitals between 1944 and 1963 with diagnoses of tetany, idiopathic hypoparathyroidism, pseudohypoparathyroidism, and postsurgical hypoparathyroidism were reviewed. The diagnosis of idiopathic References 1. Steinberg, H., and Waldron, B.R.: Idiopathic Hypoparathyroidism: An Analysis of Fifty-Two Cases, Including the Report of a New Case , Medicine 31:133-154 ( (May) ) 1952.Crossref 2. Lachman, A.: Hypoparathyroidism in Denmark: A Clinical Study , Acta Med Scand 121 ( (suppl) ):9-173, 1941. 3. Drake, T.G., et al: Chronic Idiopathic Hypoparathyroidism: Report of Six Cases , Ann Intern Med 12:1751-1765 ( (May) ) 1939.Crossref 4. Albright, F., et al: Pseudohypoparathyroidism: An Example of "Seabright-Bantam" Syndrome , Endocrinology 30:922-932 ( (June) ) 1942. 5. Hiatt, H.H., and Thompson, D.D.: The Effects of Parathyroid Extract on Renal Function in Man , J Clin Invest 36:557-565 ( (April) ) 1957.Crossref 6. Stromn, L., and Wineberg, J.: Idiopathic Hypoparathyroidism , Acta Pediat 43:574-581 ( (Nov) ) 1954.Crossref 7. Forbes, G.B.: Clinical Features of Idiopathic Hypoparathyroidism In Children , Ann NY Acad Sci 64:432-455 ( (Aug) ) 1956.Crossref 8. Schaff, M., and Payne, C.A.: Diphenylhydantoin and Phenobarbital In Overt and Latent Tetany , New Eng J Med 274:1228-1232 ( (June 2) ) 1966.Crossref 9. Gotta, H.: Tetany and Epilepsy , Arch Neurol Psychiat 66:714-721 ( (Dec) ) 1951.Crossref 10. Eaton, L.M.; Camp, J.D.; and Love, J.G.: Symmetric Cerebral Calcifications, Particularly of the Basal Ganglia, Demonstrable Roentgenographically , Arch Neurol Psychiat 41:921-942 ( (May) ) 1939.Crossref 11. Levin, P., et al: Intracranial Calcifications and Hypoparathyroidism , Neurology 11:1076-1080 ( (Dec) ) 1961.Crossref 12. Bennett, J.C.; Maffly, R.H.; and Steinbach, H.L.: The Significance of Bilateral Ganglia Calcification , Radiology 72:368-377 ( (March) ) 1959.Crossref 13. Danowski, T.S.; Lasser, E.C.; and Weschler, R.L.: Calcifications of the Basal Ganglia in Postthyroidectomy Hypoparathyroidism , Metabolism 9: 1064-1065 ( (Nov) ) 1960. 14. Frame, B.: Parkinsonism in Postoperative Hypoparathyroidism , Arch Intern Med 116:424-427, 1965.Crossref 15. Simpson, J.A.: Neurological Manifestations of Idiopathic Hypoparathyroidism , Brain 75:76-90 ( (March) ) 1952.Crossref 16. Bronsky, D.: Idiopathic Hypoparathyroidism and Pseudohypoparathyroidism , Medicine 37:317-352 ( (Dec) ) 1958.Crossref 17. Robinson, K.C.; Kellberg, M.H.; and Crowley, F.M.: Idiopathic Hypoparathyroidism Presenting as Dementia , Brit Med J 2:1203-1206 ( (Nov) ) 1954.Crossref 18. McKinney, A.S.: Idiopathic Hypoparathyroidism Presenting as Chorea , Neurology 12:485-491 ( (July) ) 1962.Crossref 19. Schaff, M., and Payne, C.A.: Dystonic Reactions to Prochlorperazine in Hypoparathyroidism , New Eng J Med 275:991-994 ( (Nov 3) ) 1966.Crossref 20. Palmer, R.F.; Searles, H.H.; and Baldrey, E.B.: Papilledema and Hypoparathyroidism Simulating Brain Tumor , J Neurosurg 16:378-384 ( (July) ) 1959.Crossref 21. Greene, J.A., and Swanson, L.W.: Psychosis in Hypoparathyroidism: Report of Five Cases , Ann Intern Med 14:1233-1236 ( (Jan) ) 1941.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Neurological Manifestations of Hypoparathyroidism

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Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.00300020074009
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Abstract

Abstract WHEN tetany occurs in a patient soon after surgery on the thyroid or parathyroid glands, hypocalcemia is immediately suspected. However, the diagnosis of hypoparathyroidism is not always so obvious, and many such patients have neurological symptoms such as seizures, increased intracranial pressure, or chorea as the primary manifestations of their hypocalcemia. Major reviews of this subject fail to stress this point.1,2 This report was prompted by the recent study of two patients who presented with neurologic symptoms and later proved to have hypoparathyroidism. These two cases will be reported in detail, and the neurological manifestations in 40 additional patients with hypoparathyroidism seen at this institution since 1944 will be presented. Material and Methods The records of all patients discharged from The University of Texas Medical Branch Hospitals between 1944 and 1963 with diagnoses of tetany, idiopathic hypoparathyroidism, pseudohypoparathyroidism, and postsurgical hypoparathyroidism were reviewed. The diagnosis of idiopathic References 1. Steinberg, H., and Waldron, B.R.: Idiopathic Hypoparathyroidism: An Analysis of Fifty-Two Cases, Including the Report of a New Case , Medicine 31:133-154 ( (May) ) 1952.Crossref 2. Lachman, A.: Hypoparathyroidism in Denmark: A Clinical Study , Acta Med Scand 121 ( (suppl) ):9-173, 1941. 3. Drake, T.G., et al: Chronic Idiopathic Hypoparathyroidism: Report of Six Cases , Ann Intern Med 12:1751-1765 ( (May) ) 1939.Crossref 4. Albright, F., et al: Pseudohypoparathyroidism: An Example of "Seabright-Bantam" Syndrome , Endocrinology 30:922-932 ( (June) ) 1942. 5. Hiatt, H.H., and Thompson, D.D.: The Effects of Parathyroid Extract on Renal Function in Man , J Clin Invest 36:557-565 ( (April) ) 1957.Crossref 6. Stromn, L., and Wineberg, J.: Idiopathic Hypoparathyroidism , Acta Pediat 43:574-581 ( (Nov) ) 1954.Crossref 7. Forbes, G.B.: Clinical Features of Idiopathic Hypoparathyroidism In Children , Ann NY Acad Sci 64:432-455 ( (Aug) ) 1956.Crossref 8. Schaff, M., and Payne, C.A.: Diphenylhydantoin and Phenobarbital In Overt and Latent Tetany , New Eng J Med 274:1228-1232 ( (June 2) ) 1966.Crossref 9. Gotta, H.: Tetany and Epilepsy , Arch Neurol Psychiat 66:714-721 ( (Dec) ) 1951.Crossref 10. Eaton, L.M.; Camp, J.D.; and Love, J.G.: Symmetric Cerebral Calcifications, Particularly of the Basal Ganglia, Demonstrable Roentgenographically , Arch Neurol Psychiat 41:921-942 ( (May) ) 1939.Crossref 11. Levin, P., et al: Intracranial Calcifications and Hypoparathyroidism , Neurology 11:1076-1080 ( (Dec) ) 1961.Crossref 12. Bennett, J.C.; Maffly, R.H.; and Steinbach, H.L.: The Significance of Bilateral Ganglia Calcification , Radiology 72:368-377 ( (March) ) 1959.Crossref 13. Danowski, T.S.; Lasser, E.C.; and Weschler, R.L.: Calcifications of the Basal Ganglia in Postthyroidectomy Hypoparathyroidism , Metabolism 9: 1064-1065 ( (Nov) ) 1960. 14. Frame, B.: Parkinsonism in Postoperative Hypoparathyroidism , Arch Intern Med 116:424-427, 1965.Crossref 15. Simpson, J.A.: Neurological Manifestations of Idiopathic Hypoparathyroidism , Brain 75:76-90 ( (March) ) 1952.Crossref 16. Bronsky, D.: Idiopathic Hypoparathyroidism and Pseudohypoparathyroidism , Medicine 37:317-352 ( (Dec) ) 1958.Crossref 17. Robinson, K.C.; Kellberg, M.H.; and Crowley, F.M.: Idiopathic Hypoparathyroidism Presenting as Dementia , Brit Med J 2:1203-1206 ( (Nov) ) 1954.Crossref 18. McKinney, A.S.: Idiopathic Hypoparathyroidism Presenting as Chorea , Neurology 12:485-491 ( (July) ) 1962.Crossref 19. Schaff, M., and Payne, C.A.: Dystonic Reactions to Prochlorperazine in Hypoparathyroidism , New Eng J Med 275:991-994 ( (Nov 3) ) 1966.Crossref 20. Palmer, R.F.; Searles, H.H.; and Baldrey, E.B.: Papilledema and Hypoparathyroidism Simulating Brain Tumor , J Neurosurg 16:378-384 ( (July) ) 1959.Crossref 21. Greene, J.A., and Swanson, L.W.: Psychosis in Hypoparathyroidism: Report of Five Cases , Ann Intern Med 14:1233-1236 ( (Jan) ) 1941.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 1, 1967

References