Acute Onset of Quadriplegia Secondary to Hypoparathyroidism: Mimicker of AMAN Variant of GBS

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
Syeda Saba ZaidiSarwar Jamil Siddiqui

Abstract

Acute onset of quadriplegia is a rare phenomenon seen with hypocalcemia due to hypoparathyroidism. We describe a 33-year gentleman who presented with weakness of all four limbs and areflexia. ECG showed QT abnormality. Nerve conduction study revealed normal sensory and significantly low motor CMAP amplitudes in both the upper and lower extremities. This nerve conduction study can be seen in acute motor neuropathy of various etiologies, among which GBS is the most worrisome. Our patient found to have low calcium and parathyroid hormone level. His symptoms improved after calcium replacement. Occurrence of quadriplegia in hypoparathyroidism, and its improvement after correction of calcium, suggests crucial role of calcium in neuromuscular transmission. One should suspect electrolyte imbalance, like hypocalcemia in patients presenting with nerve conduction features of AMAN variant of GBS.

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