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

摘要

Extensive intracranial calcifcation 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 hypocalcaemiaand clinical features of Parkinsonism. On detailed evaluation, patient was found to have extensive calcifcation involving the basalganglia, periventricular white matter and cerebellum and serum parathormone was low. With calcium and calcitriol supplementationthere was symptomatic improvement however features of parkinsonism persisted. We present this case to highlight the unusualpresentation of Parkinsonism in a patient with post-thyroidectomy hypoparathyroidism with brain calcinosis. This case alsounderscores the importance of regular follow-up of patients after thyroid surgery to detect hypoparathyroidism, the treatment ofwhich could prevent future morbidity to the patient.