Hyperparathyroidism Associated with Parkinsonism.

Abstract

A 70-year-old woman with hyperparathyroidism associated with parkinsonism is reported. Her primary initial symptom was parkinsonism, but it was levodopa-resistant. Chemical and hormonal findings revealed that she had hyperparathyroidism. The symptoms were relieved after the surgical removal of a parathyroid adenoma. Although this type of case has been reported only rarely, it suggests that hypercalcemia might be an aggravating factor in levodopa resistant parkinsonism. (Internal Medicine 31: 904-907, 1992)

Parkinsonism as an Atypical Manifestation of Primary Hyperparathyroidism

“…Unlike other cases with a prior diagnosis of parkinsonism (2,6), our patient was only diagnosed during the period of hospitalization through neurological examination. This contributes to the hypothesis that the beginning of parkinsonism symptomatology is due to the electrolytic disturbance of calcium or possibly neurotoxic levels of parathyroid hormone (6,21), caused by parathyroid hyperfunction. We found parathyroidectomy provided an immediate relief of drowsiness and significant improvement of parkinsonian symptoms, with a subsequent complete remission of parkinsonian symptoms after 4 weeks of treatment with levodopa.…”

“…In the literature, the association between hypoparathyroidism and parkinsonism have been frequently reported, while evidence of hyperparathyroidism associated with parkinsonism is rare (2,(6)(7)(8)(9)(10)(11). The present study reports the case of a patient that had PHPT and developed symptoms of parkinsonism.…”

“…Due to the scarcity of cases of PHPT causing parkinsonism, there is still no clarification regarding the exact mechanism responsible for this association, only various hypotheses (2,(6)(7)(8)(9)(10)(11). Parkinson disease is characterized by a decrease in dopaminergic levels in the nigrostriatal pathways of the brain.…”

“…Other studies have demonstrated an association between the onset of parkinsonism and intracranial calcifications, which are more frequent in the clinical presentation of hypoparathyroidism and, more rarely, are associated with hyperparathyroidism (6,19,20). However, this hypothesis of causality is controversial in the literature, since a few other reported cases demonstrated the correlation between parkinsonism and hyperparathyroidism in the absence of intracranial calcifications (2,6).…”

Diagnostic considerations in juvenile parkinsonism

“…Hypo‐ and hypercalcaemia as a consequence of hypoparathyroidism, pseudohypoparathyroidism, and hyperparathyroidism have been reported as causes in the literature 114–117. In addition to these cases, familial idiopathic basal ganglia calcification has been associated with parkinsonism in patients in their 30s 118.…”