Objective: There may be overlap between symptoms of hypoparathyroidism such as tremor and bradykinesia and Parkinsonism. Recognizing this possibility allows for appropriate clinical management.

Background: Parkinsonism may occur in patients with hypoparathyroidism. Secondary hypoparathyroidism can be treated with appropriate supplementation and low risk of adverse events.

Method: Medline was searched with keyword of hypoparathyroidism and Parkinson’s disease or parkinsonism. Non-familial case reports were included. Familial 22.q11.2 deletion syndrome cases were not included.

Results: 3 publications were included. Clarke (1962) describes a case in which tremor and rigidity improved after treatment of the hypoparathyroidism. El Aoud describes 16 patients who also improved with hypoparathyroidism treatment. Faisal (2021) reports complete resolution of parkinsonism and corticobasal syndrome clinical symptomatology after intravenous calcium followed by oral calcium and Vitamin D.

Conclusion: Disorders of calcium due to hypoparathyroidism should be considered in the workup of Parkinson’s disease and parkinsonism. Improvement of symptoms after Calcium and Vitamin D supplementation in secondary hypoparathyroidism has been reported.

References: Clarke HA, Frame, B Parkinson’s Disease Associated With Hypoparathyroidism. Henry Ford Hospital Medical Bulletin 1962: 10 (1) : 51-53.
El Aoud S, Elleuch M, Charfi N, Hadj Kacem F, Mnif M, Rekike N, Mnif F, Abid M. Fahr’s syndrome in Southern Tunisia: A broad spectrum of clinical and etiological features. Tunis Med. 2018 Aug-Sep;96(8-9):490-494. PMID: 30430526.
Faisal M, Kukkle PL. Hypoparathyroidism Masquerading as Corticobasal Syndrome. Mov Disord Clin Pract. 2021 Apr 3;8(4):600-603. doi: 10.1002/mdc3.13182. PMID: 33981794; PMCID: PMC8088101.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsonism-in-setting-of-hypoparathyroidism/