NEUROPSYCHIATRIC ASPECTS OF PRIMARY HYPER PARATHYROIDISM

Over a period of 3 months a 51-year-old woman developed a depressive s yndrome with loss of memory, inability to find words, impaired fine mo vements and phases of spacial disorientation. Biochemical tests demons trated occasional slight rises in serum calcium (2.8-2.9 mmol/l) and p arathormone (4.6-5.2 pmol/l). She had a grade II nodular goitre with n ormal thyroid function. Ultrasonography of the thyroid suggested a rig ht cranial parathyroid adenoma, confirmed at a right thyroidectomy wit h resection of the right upper parathyroid, while the other parathyroi d glands were grossly normal. Calcium and parathormone levels returned to normal after the operation, as did the neuropsychiatric symptoms ( within two months). - This typical case illustrates that even in seemi ngly isolated neuropsychiatric changes an organic disease, like primar y hyperparathyroidism, needs to be thought of.