SYMPTOMATIC postoperative hypoparathyroidism is a well-recognized but infrequent complication of subtotal thyroidectomy. Subclinical degrees of parathyroid insufficiency, however, probably occurs in a significantly larger proportion of patients.1When present, symptoms are probably related to the resultant deficiency in serum calcium, and include neuromuscular abnormalities with paresthesias and tetany; ectodermal changes with cataract formation, and abnormalities of skin, hair, teeth, and nails; and signs of central-nervous-system dysfunction with anxiety, psychosis, signs of increased intracranial pressure and, rarely, convulsions. The neuromuscular abnormality is usually the first manifestation of parathyroid deficiency, tending to occur early in the postoperative period. Ectodermal changes appear late in the untreated disease and probably are related to the duration of hypocalcemia as well as to its degree.2Central-nervous-system manifestations are variable in temporal occurrence, usually beginning relatively early postoperatively3and rarely occurring as a late manifestation many years after thyroid surgery.4,5The patient reported