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[Neurological complications in hyperparathyroidism]

F Trebini1, A Appiotti, R Bacci

  • 1Divisione di Neurologia, Ospedale Mauriziano Umberto I, Torino.

Minerva Medica
|February 1, 1993
PubMed
Summary

Primary hyperparathyroidism can cause spinal amyotrophy, a rare neurological condition. This case study highlights the diagnostic challenges and the importance of metabolic screening for neuromuscular symptoms.

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Area of Science:

  • Neurology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Amyotrophy, characterized by muscle wasting, can present with varied etiologies.
  • Primary hyperparathyroidism is a metabolic disorder typically associated with bone and kidney complications.
  • Neurological manifestations of hyperparathyroidism are uncommon but recognized.

Observation:

  • A 57-year-old patient presented with amyotrophy of the pelvic and pectoral girdles and limb roots.
  • Clinical examination revealed brisk and symmetric deep tendon reflexes (R.O.T.) without fasciculations, sensory deficits, bulbar signs, or pathological reflexes.
  • Electromyography (EMG) confirmed neurogenic involvement in all four limbs, with normal serum muscle enzymes.

Findings:

  • Laboratory investigations identified primary hyperparathyroidism due to a single parathyroid adenoma.

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  • Further testing excluded multiple endocrine adenomatosis.
  • The findings suggest a link between hyperparathyroidism and spinal amyotrophy.

    • Implications:

    • This case underscores the importance of considering metabolic disorders, such as hyperparathyroidism, in the differential diagnosis of unexplained amyotrophy.
    • Early diagnosis and management of hyperparathyroidism may prevent or reverse neurological complications.
    • Further research is warranted to elucidate the mechanisms underlying nervous system involvement in hyperparathyroidism.