Hypoparathyroidism may cause impairment that can be measured using the AMA criteria.
Clinical scenario: Permanent impairment typically arises after surgical removal of the parathyroid glands.
Parameters:
(1) hypocalcemia and response to therapy
(2) signs and symptoms
Signs and symptoms:
(1) Chvostek's sign (contraction of facial muscles induced by light tapping of the facial nerve)
(2) Trousseau's sign (carpopedal spasm seen after placing a blood pressure cuff on the forearm and raising the pressure above the systolic blood pressure)
(3) tetany
(4) perioral and/or peripheral paresthesia
(5) muscular irritability, often worsened by exercise
(6) prolongation of QT interval on ECG
(7) laryngospasm
(8) generalized convulsions
(9) encephalopathy with dementia or psychosis
Hypocalcemia |
Symptoms |
Impairment of the Whole Person |
minimal, no therapy required |
none |
0% |
therapy effective |
none with therapy |
0 - 9% |
partially effective |
symptomatic despite therapy |
10 – 20% |
where:
• A person with severe hypoparathyroidism would have more than 20% whole person impairment; however, many of the serious complications (encephalopathy, seizures, etc.) would be transient rather than permanent. The degree of impairment here needs to be combined with any long-term neurologic impairment.
Specialty: Sports Medicine & Rehabilitation, Endocrinology