HYPERPARATHYROIDISM WITH FORWARD SAGGING OF THE HEAD AS THE 1ST MANIFESTATION

An unusual clinical presentation of hyperparathyroidism is reported. T he 73-year-old patient was unable to maintain her head upright after t en minutes of walking or standing. Parathyroid adenoma was diagnosed o n the basis of ultrasound and pathological findings and parathyroid ho rmone assays. Following surgery the forward sagging of the head no lon ger occurred and serum levels of calcium and phosphorus returned to no rmal. Pathophysiological hypotheses are discussed. No similar cases wi th isolated weakness of the cervical and dorsal paravertebral muscles has been reported to date.