Parkinsonism secondary to iatrogenic hypoparathyroidism

ABSTRACT

Parkinsonism is a clinical syndrome characterized by bradykinesia, rigidity, and tremor. Many causes have been identified for secondary parkinsonism. Among them, hypocalcemia due to hypoparathyroidism is one of the rarer causes. Here, we emphasized a patient presented with reversible secondary parkinsonism caused by hypocalcemia due to iatrogenic hypoparathyroidism following thyroidectomy. A 56-year-old female diagnosed with hypothyroidism and parkinsonism was admitted following a lower respiratory tract infection. She had undergone a total thyroidectomy 10 years ago, following which there were intermittent episodes of hypocalcemia. The patient was found to have hypocalcemia, hypophosphatemia, and low parathyroid hormone level. The noncontrast computed tomography of the brain showed diffuse brain calcification with a predilection to basal ganglia. Her diagnosis was refined as parkinsonism due to cerebral calcification secondary to iatrogenic hypoparathyroidism. This case emphasized the importance of evaluating treatable secondary causes of parkinsonism at diagnosis.