Recurrent Severe Spasmophylia from Hypocalcaemia: A Case Report


  • Rizaldy Taslim Pinzon Department of Neuorology Bethesda Hospital Yogyakarta
  • Ruth Vanessa Gloria Sinaga Faculty of Medicine Universitas Kristen Duta Wacana Yogyakarta



Calcium, hypocalcemia, spasmophilia


Hypocalcemia can present with a variety of clinical symptoms and indications. In situations of nerve-related hypocalcemia, muscle cramps and tetany are signs of increased excitability in either peripheral nerves or the central nervous system. Here, we described the case of a 58-year-old woman experiencing ongoing pain and cramping in both her upper and lower extremities. Through careful physical, neurophysiological, and radiological examinations, we were able to identify hypocalcemia as the primary cause of her severe muscle spasms and cramps, known as spasmophilia. Further detailed history-taking revealed a past total thyroidectomy. Administration of adequate calcium supplementation successfully relieved the symptoms.


Download data is not yet available.


Bilezikian JP. Hypoparathyroidism. The Journal of Clinical Endocrinology & Metabolism. 2020; 105(6): 1722–1736.

Goyal A, Anastasopoulou C, Ngu M, and Singh S. Hypocalcemia. (Online) StatPearls 2023. [accessed 2023 September 28]

Cusano NE and Bilezikian JP. Signs and Symptoms of Hypoparathyroidism. Endocrinology and Metabolism Clinics of North America. 2018; 47(4): 759–770.

Min H and Lee HC. Electromyographic Changes in a Patient with Hypocalcemia after Thyroidectomy: A Case Report. Turkish Journal of Physical Medicine and Rehabilitation. 2022; 68(3): 422–425.

Patel M and Hu EW. Trousseau Sign. (Online) StatPearls 2023. http://www.ncbi.nlm.nih. gov/books/NBK557832/ [accessed 2023 September 28]

Mannstadt M, Bilezikian JP, Thakker RV, et al. Hypoparathyroidism. Nature Reviews Disease Primers. 2017; 3(1): 17055.

Giusti F and Brandi ML. Clinical Presentation of Hypoparathyroidism. Frontiers of Hormone Research. 2019; 51: 139–146.

Hosseini M, Otaghvar HA, Tizmaghz A, Shabestanipour G, and Vahid PA. Evaluating the Time Interval for Presenting the Signs of Hypocalcaemia after Thyroidectomy. Journal of Clinical and Diagnostic Research. 2016; 10(3): 19-22.

Hans SK and Levine SN. Hypoparathyroidism. (Online) StatPearls 2023. http:// [accessed 2023 September 28]

Hujoel IA. The Association between Serum Calcium Levels and Chvostek Sign: A Population-Based Study. Neurology. Clinical Practice. 2016; 6(4): 321–328.

Beneki E, Papazarkadas X, Karras A, Kalantzis K, and Tsatiris K. A Rare Case of Fahr's Syndrome in a Patient with Secondary Hypoparathyroidism and Neuropsychiatric Symptoms. Innovations in Clinical Neuroscience. 2021; 18(4–6): 11–14.

Mendes EM, Meireles-Brandão L, Meira C, Morais N, Ribeiro C, and Guerra D. Primary Hypoparathyroidism Presenting as Basal Ganglia Calcification Secondary to Extreme Hypocalcemia. Clinics and Practice. 2018; 8(1): 5-7.

Zavatta G and Clarke BL. Basal Ganglia Calcification in Hypoparathyroidism and Pseudohypoparathyroidism: Local and Systemic Metabolic Mechanisms. Journal of Endocrinological Investigation. 2021; 44(2): 245–253.

Deng H, Zheng W, and Jankovic J. Genetics and Molecular Biology of Brain Calcification. Ageing Research Reviews. 2015; 22: 20–38.

Sanabria A, Rojas A, and Arevalo J. Meta-Analysis of Routine Calcium/Vitamin D3 Supplementation Versus Serum Calcium Level-Based Strategy to Prevent Postoperative Hypocalcaemia after Thyroidectomy. The British Journal of Surgery. 2019; 106(9): 1126–1137.

Pepe J, Colangelo L, Biamonte F, et al. Diagnosis and Management of Hypocalcemia. Endocrine. 2020; 69(3): 485–495.

Bollerslev J, Rejnmark L, Marcocci C, et al. European Society of Endocrinology Clinical Guideline: Treatment of Chronic Hypoparathyroidism in Adults. European Journal of Endocrinology. 2015; 173(2): 1–20.

Susanti L, Indra S, and Noza A. Spasmofilia dengan Hipoparatiroidisme Pasca Tiroidektomi. Scientific Journal. 2022; 1(4): 290–298.

Coudenys E, Meerhaeghe TV, Unuane D, Buyl R, and Bravenboer B. Long-Term Treatment with Calcitriol in Postsurgical Hypoparathyroidism Leads to Renal Function Decline. Hormone and Metabolic Research. 2019; 51(6): 362–366.

Brandi ML, Bilezikian JP, Shoback D, et al. Management of Hypoparathyroidism: Summary Statement and Guidelines. The Journal of Clinical Endocrinology and Metabolism. 2016; 101(6): 2273–2283.



2024-02-29 — Updated on 2024-02-29



Case Report

Most read articles by the same author(s)