Neuromuscular symptoms in elderly patients with hyperparathyroidism: improvement with parathyroid surgery.
In a consecutive series of 100 neck explorations for primary hyperparathyroidism, 42 patients were 60 years of age or older; in this group of elderly patients the surgical cure rate was 100%. These patients were reviewed retrospectively by means of a structure interview. Twenty-one patients had had preoperative neuromuscular symptoms that ranged from coma to subjective muscular weakness. These patients had significantly-higher preoperative serum calcium and parathyroid hormone levels than did 21 patients without neuromuscular symptoms (P = 0.003 and P = 0.046, respectively). Most of the neuromuscular symptoms improved in the postoperative period. In particular, 15 of 17 patients with muscle weakness reported a significant improvement, while 14 of 15 patients who suffered from fatigue and lethargy reported an improvement. An improvement also occurred in the level of day-to-day function in eight patients. While surgery for primary hyperparathyroidism generally is undertaken for a specific indication, such as severe hypercalcaemia or renal stones, it appears from this study that neuromuscular symptoms also may improve, particularly in elderly patients.
Delbridge
L W
LW
University of Sydney Department of Surgery, Royal North Shore Hospital of Sydney, St Leonards, NSW.
Marshman
D
D
Reeve
T S
TS
Crummer
P
P
Posen
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000209:etiology* / Q000503:physiopathology; D010280:Parathyroid Glands / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies