A Rare Case of Extensive Brain Calcinosis and Features of Parkinsonism Secondary to Iatrogenic Hypoparathyroidism

Abstract

Extensive intracranial calcification is rare in iatrogenic hypoparathyroidism and Parkinsonism at the time of diagnosis is uncommon. We report a case of a 55-year-old woman who presented to us 20 years after thyroid surgery with symptoms of hypocalcaemia and clinical features of Parkinsonism. On detailed evaluation, patient was found to have extensive calcification involving the basal ganglia, periventricular white matter and cerebellum and serum parathormone was low. With calcium and calcitriol supplementation there was symptomatic improvement however features of parkinsonism persisted. We present this case to highlight the unusual presentation of Parkinsonism in a patient with post-thyroidectomy hypoparathyroidism with brain calcinosis. This case also underscores the importance of regular follow-up of patients after thyroid surgery to detect hypoparathyroidism, the treatment of which could prevent future morbidity to the patient.

Keywords

• calcification
• hypocalcaemia
• parathormone
• thyroidectomy