SEIZURES AND HYPOPARATHYROIDISM

Should tetany develop in a patient shortly after surgery on his thyroid or parathyroid glands, hypocalcemia would immediately be suspected. However hypocalcemia may produce symptoms whose cause is much less obvious, and the first manifestations of hypoparathyroidism may be serious neurological symptoms, including seizures, movement disorders, or increased intracranial pressure. Fonseca and Calverley, in a recent issue of theArchives of Internal Medicine1reviewed the records of 42 patients with hypoparathyroidism, including seven with idiopathic hypoparathyroidism. As might be predicted, tetany was the most common symptom and occurred in 30 patients. However, seizures occurred in 12 patients and were especially common in those patients with idiopathic hypoparathyroidism. Several patients were observed to have generalized seizures without associated tetany and without positive signs of Trousseau and Chvostek, perhaps because these usual hallmarks of hypocalcemia may be abolished by anticonvulsants.2One patient had transient chorea that was relieved by correcting