Complications after parathyroidectomy. Fractures from low calcium and magnesium convulsions.

symptoms are mild, the hypocalcaemia temporary, and treatment is not required. In a few, those with renal disease, bone disease or steatorrhoea, the hypocalcaemia is likely to be severe and need treatment. The routine management of this type of patient has been described by Dent (1962). We have recently studied two patients who had generalised convulsions after parathyroidectomy despite this routine treatment. The first patient, who had primary hyperparathyroidism with severe bone disease, developed hypomagnesaemia in addition to hypocalcaemia. The second patient underwent total parathyroidectomy for renal osteodystrophy secondary to polycystic disease of the kidneys, and developed severe hypocalcaemia which failed to respond until aluminium hydroxide was added to the routine therapy of calcium and vitamin D. In both patients severe tetany with convulsions caused multiple fractures. We wish to record these patients and make suggestions which should improve treatment after