Background: Parathyroid failure is the most common complication after total thyroidectomy but permanent impairment of the parathyroid function is unusual. Limited data is available assessing long-term follow-up, quality of life and complications occurring in patients with permanent hypoparathyroidism (PH).We aimed to assess the incidence of complications derived from PH status, their influence on the quality of life perceived by PH patients and its relation to standard medical treatment with calcium salts and active vitamin D analogues.Methods: Cross-sectional observational study of consecutive patients undergoing total thyroidectomy who developed PH and were followed at least twice a year at a referral endocrine surgery unit. PH was defined as intact parathyroid hormone (iPTH) levels <13 pg/mL and the need for replacement therapy with calcium and/or vitamin D for at least 1 year after surgery. Quality of life was assessed using the SF-36 questionnaire.Data regarding doses and type of vitamin D analogues and calcium supplementation, serum calcium fluctuations, bone densitometry and renal ultrasound were recorded. Results:The cohort included 32 patients (3 male/29 female) with a mean age of 51.2±15.2 years. The mean follow-up was 78±68 months and the total follow-up length was 70,080 PH patient/days. Five (15.6%) patients showed a decreased renal function. At least one clinical adverse event was observed in 18 (56.3%)patients. There was a slight decrease of the punctuation in the SF-36 questionnaire for the perceived quality of life that was only significant for the emotional role.Conclusions: PH and its treatment carry a mild to moderate burden of illness if followed closely. During a mean follow-up of nearly 6 years, only half of the patients suffered a relevant clinical event with little impact on their quality of life.

About 30% of adults suffer from some mild to severe vestibular dysfunction. Vestibular disorders can be expressed as acute vestibular syndrome (AVS), episodic vestibular syndrome. Only half of the sufferers can compensate for their dysfunction after three months after the onset, while the other half of them become chronic, the mechanisms behind this compensation remain unclear. Several behavioural studies have explored the role of the vestibulo-ocular reflex and saccades in the process, linking to the interaction between the superior colliculus and the cerebellum. Yet, despite cerebellar involvement in vestibular function and oculomotor adaptation, thus far, no studies have focused on the specific role of the cerebellum in the compensation process in vestibular dysfunction. In this study, we test the hypothesis that undiagnosed cerebellar dysfunction might hinder chronic vestibulopathy sufferers from compensating and recovering. We recruited 19 patients who had suffered from an acute peripheral vestibular syndrome (10 clinically recovered and 9 with chronic symptoms) and ten individuals with no history of vestibular alterations (controls). We assessed their implicit motor learning capacity with a visuomotor rotation task and measured by the angular aiming error, which showed an impaired implicit motor adaptation in chronic patients compared to recovered and control groups. These findings indicate the involvement of the cerebellum in vestibular compensation and suggest that implicit motor adaptation of reaching movements could be potentially used as an early prognostic tool in unilateral peripheral vestibular dysfunction (UPVD) patients.

BACKGROUND About 30% of adults suffer from some mild to severe vestibular dysfunction. Vestibular disorders can be expressed as acute vestibular syndrome (AVS), episodic vestibular syndrome. Only half of the sufferers can compensate for their dysfunction after three months after the onset, while the other half of them become chronic, the mechanisms behind this compensation remain unclear. Several behavioural studies have explored the role of the vestibulo-ocular reflex and saccades in the process, linking to the interaction between the superior colliculus and the cerebellum. Yet, despite cerebellar involvement in vestibular function and oculomotor adaptation, thus far, no studies have focused on the specific role of the cerebellum in the compensation process in vestibular dysfunction. OBJECTIVE In this study, we test the hypothesis that undiagnosed cerebellar dysfunction might hinder chronic vestibulopathy sufferers from compensating and recovering. METHODS We recruited 19 patients who had suffered from an acute peripheral vestibular syndrome (10 clinically recovered and 9 with chronic symptoms) and ten individuals with no history of vestibular alterations (controls). RESULTS We assessed their implicit motor learning capacity with a visuomotor rotation task and measured by the angular aiming error, which showed an impaired implicit motor adaptation in chronic patients compared to recovered and control groups. CONCLUSIONS These findings indicate the involvement of the cerebellum in vestibular compensation and suggest that implicit motor adaptation of reaching movements could be potentially used as an early prognostic tool in unilateral peripheral vestibular dysfunction (UPVD) patients.