Epileptic seizure, as the first symptom of hypoparathyroidism in children, does not require antiepileptic drugs

Abstract

ObjectivePatients with hypoparathyroidism exhibit metabolic disorders (hypocalcemia) and brain structural abnormalities (brain calcifications). Currently, studies have determined whether antiepileptic drug (AED) treatment is required for epileptic seizures in children with hypoparathyroidism.MethodThis study aims to evaluate the data of two medical centers in Beijing based on the diagnosis of epileptic seizures as the first symptom of hypoparathyroidism in children.ResultA total of 42 patients were included and assigned into AED and non-AED treatment groups in a 1:2 matched case–control study. Results show that the seizure outcome after 1 year of AED treatment is not significantly different from that of the control. In the subgroup analysis of patients with subcortical calcifications, the seizure outcome is still not significantly different from that of the control.ConclusionThus, AED treatment cannot improve the seizure outcomes in children with parathyroid disorder, even in such cases as suspected structural seizure caused by subcortical calcifications. Clinicians must take adequate considerations on the use of AEDs in these patients. Epileptic seizures, as the first symptom of hypoparathyroidism in children, do not require epilepsy drugs.

Epileptic Seizures as te First Manifestation of Fahr’s Syndrome

“…Presently there are no specific guidelines regarding the efficiency of the anti-epileptic treatment in inducing the resolution of seizures in patients with hypocalcemia and cerebral calcifications (15). A trial exploring the efficiency of anti-epileptic therapy performed on a limited number of patients with hypoparathyroidism and epileptic seizures as the first symptom showed no significant difference in terms of seizure-free time between the treatment and notreatment groups; the treatment made no difference even in the subset of patients with subcortical calcifications; however seizure suppression seemed to be significantly correlated with calcium level normalization (15).…”

Fahr’s Syndrome Presenting With Hypocalcemia and Psychotic Features

“…She receives regular calcium replacement (calcium carbonate) and vitamin D for hypoparathyroidism. It is worth mentioning that calcium levels must be monitored and maintained as suppression of the seizure appears to be strongly associated with the normalization of calcium levels [ 19 ]. Whenever the diagnosis is made early, and the underlying condition is treated accordingly, the process of calcification could recede [ 9 ].…”

Primary hypoparathyroidism: hypocalcaemia misdiagnosed as epilepsy

“…As such, the diagnosis of hypoparathyroidism was not made for years until the present admission. Identification and treating the root of the problem, hypocalcaemia, is imperative as antiepileptic drugs will not improve outcomes, exposing patients to unnecessary pill burden and further side effects 3 4…”