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Calcification of the basal ganglia as a cause of levodopa‐resistant parkinsonism

We present a patient with levodopa-resistant parkinsonism due to basal ganglia calcification related to surgically-induced hypoparathyroidism. The calcification was seen on computerized axial tomography but not on skull x-rays. Such calcification should be looked for in all cases of levodopa-resistant parkinsonism, since it is possible that treatment of hypoparathyroidism may halt progression of the disease. This case with similar ones from the literature suggest that striatal disease itself can cause parkinsonism and that the parkinsonism in such patients tends to be less responsive or nonresponsive to levodopa.