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Neuropsychiatric disorders in primary hyperparathyroidism.

T Hayabara, K Hashimoto, H Izumi

The Japanese Journal of Psychiatry and Neurology

|March 1, 1987

Summary

Primary hyperparathyroidism (PHPT) can cause mental health issues like depression and paranoia. Surgical removal of parathyroid adenomas resolved these symptoms and improved EEG findings in two patients.

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Area of Science:

Neurology
Endocrinology
Psychiatry

Background:

Primary hyperparathyroidism (PHPT) is a condition characterized by excessive parathyroid hormone secretion.
Hypercalcemia, a common consequence of PHPT, can manifest with a range of neurological and psychiatric symptoms.
The interplay between hypercalcemia and mental status changes requires further elucidation.

Observation:

Two middle-aged women presented with depression and paranoid states, with hypercalcemia identified during treatment.
Diagnosis of PHPT was confirmed by surgical identification of parathyroid adenomas in both cases.
Antipsychotics provided transient relief in one case, while levodopa and hypercalcemia may have interacted synergistically in the other.

Findings:

Surgical correction of PHPT led to the resolution of psychiatric symptoms and normalization of serum calcium levels.
Electroencephalogram (EEG) abnormalities, including slow waves and low voltage activity preoperatively, improved to regular hypersynchronous alpha activity post-surgery.
No recurrence of symptoms or hypercalcemia was observed at 12 and 18 months post-operation.

Implications:

This report highlights the significant impact of hypercalcemia in PHPT on mental health and neurological function.
Surgical management of PHPT can effectively reverse psychiatric manifestations and normalize EEG findings.
Further research into the mechanisms underlying hypercalcemia-induced psychiatric symptoms and EEG changes is warranted.

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