Following a thyroidectomy, a 42 year old woman exhibits tingling and spasms. What is the most likely diagnosis?

The symptoms of tingling and spasms exhibited by the patient following a thyroidectomy are indicative of hypocalcemia. This condition can occur post-surgery due to damage or removal of the parathyroid glands, which are responsible for maintaining calcium levels in the blood.

When the parathyroid glands are not functioning properly, there can be inadequate secretion of parathyroid hormone (PTH), leading to decreased calcium resorption from bones, reduced intestinal absorption of calcium, and increased renal excretion of calcium. The resulting low levels of calcium in the bloodstream can cause neuromuscular irritability, presenting as tingling (paresthesia) and muscle spasms (tetany).

In contrast, conditions such as thyroid storm are characterized by hyperthyroid symptoms and are not typically associated with post-thyroidectomy changes. Hyperparathyroidism, while it involves the parathyroid glands, would lead to hypercalcemia rather than hypocalcemia. Unilateral recurrent laryngeal nerve injury primarily affects voice quality and might present with hoarseness but does not typically cause the kind of neuromuscular symptoms described in this scenario. Understanding the physiological consequences of thyroid surgery and the role of calcium regulation helps clarify why hypocalcemia is the