[Tetanic equivalents, cephalgia, absences]

Abstract

Real hypoparathyroidism may develop after surgery of the thyroid, more rarely of the parathyroid. The idiopathic form is thought to be connected with autoimmune processes. We present the case of a female patient with acquired hypoparathyroidism after strumectomy 40 years ago. A clinical picture, not only with neurologic and dermatologic manifestations but also late organic sequelae of chronic hypocalcemia, i.e. calcification of basal ganglia, had developed impressively. Without the proof of laboratory tests diagnosis is difficult to establish at the first go in medical practice, since clinical symptoms may be few or widely scattered. Since the rate of strumectomies has dropped as a consequence of restricted indications, acquired hypoparathyroidism has become rarer. A simple long-term treatment with vitamin D and calcium relieves the patient from tetanic problems and prevents severe and irreversible late organic lesions.