“…Tetany is one of the postoperative complications, resulting from hyperexcitability at the neuromuscular junction, usually caused by hypocalcaemia (Brown, 1911). The mechanisms of the postoperative hypocalcaemia and tetany are disputed and have yet to be clarified: these conditions have been suggested to be due to surgical interference with the parathyroids (Wade et al, 1965;Parfitt, 1971;Escobar-Jimines et al, 1977), abnormal release of calcitonin by manipulating the thyroid gland at operation (Wilkin et al, 1977) and the sudden reversal of thyrotoxic osteodystrophy present before thyroidectomy, which leads to a rapid skeletal uptake of calcium referred to as the 'hungry bone syndrome' (Michie et al, 1971;Laitinen, 1976;Jones & Davidson, 1987). These studies were conducted focusing mainly on bone and calcium metabolism in relation to postoperative hypocalcaemia and tetany, in a relatively small number of patients with Graves' disease.…”