Síndrome confusional agudo por adenoma paratiroideouna enfermedad metabólica de tratamiento quirúrgico

1. Víctor Jacinto Ovejero Gómez
2. Laura Nieto García
3. Á. Pérez Martín
4. I. Berrio Obregón
5. J. R. López Lanza
6. Alfredo Ingelmo Setién

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DOI: 10.1016/S1132-8460(07)73512-2 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Revista Española de Enfermedades Metabólicas Oseas

Abstract

The differential diagnosis of acute confusional state encompasses a large number of processes including metabolic diseases. The diagnosis of hyperparathyroidism as a cause of acute confusional state should rest on biological parameters; treatment should initially be focused on correcting the neuropsychological disorder and then definitive surgical treatment should be undertaken to reverse bone demineralization and ulterior mortality related to hypercalcemia. The surgical approach should be carried out by experienced surgeons with the principal aim of extirpating the diseased gland using the least aggressive techniques possible. Preoperative imaging studies can help to ensure a selective approach that obviates bilateral cervical exploration. Intraoperative determination of intact parathyroid hormone (PTHi) levels or the use of a gamma probe help to ensure an effective surgical solution.

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