Fahr's disease presenting as Parkinson's disease along with dysphagia and dysarthria: A case report

Abstract

Key Clinical Message Fahr's disease, a rare motor and neurocognitive condition, is characterized by idiopathic calcification of basal ganglia. This article presents such case of 61‐year‐old female, exhibiting movement, speech, and swallowing difficulties with multiple calcifications in brain in NCCT. Early and supportive management can lead to improved outcomes and prevent unnecessary interventions.

Fahr’s Syndrome Secondary to Hypoparathyroidsm Mimicking as Parkinson’s Disease: A Case Report

“…Fahr's syndrome is usually a bilateral and symmetrical intra-cranial calcification with a predilection for basal ganglia and dentate nucleus. Moreover, primary hyperparathyroidism has been closely described in relation with the bilateral calcific nature of Fahr's syndrome [2,5] . However other causes such as lupus, tuberous sclerosis, Alzheimer's, muscular dystrophy and mitochondrial diseases have also been described to be the underlying condition predisposing Fahr's syndrome [5,6] .…”

“…The common clinical features include headaches, seizures, and movement disorders. Gait disturbances, dystonia, paresis, speech alterations, dementia, tremors, chorea are other specific features seen in Fahr's syndrome [2,5] . This combination of neuropsychiatric features along with striopallidodentate calcinosis is known as Fahr's syndrome [5] .…”

“…Batla et al in their review article pointed psychiatric features, movement disorders and cognitive impairment to be the major manifestations of Fahr's syndrome [8] . Moreover, Batla et al have also found that the evidence of basal ganglia calcification in NCCT head could be as high as 20%, which shall thus be differentiated with the primary condition of Fahr's syndrome [2,4,5,8] . Laboratory examinations should also aim for blood calcium, iPTH, and other routine blood tests which helps in differentiation of idiopathic Fahr's disease with Fahr's syndrome [5] .…”

“…Fahr's disease should be differentiated from Fahr's syndrome, which is usually secondary to underlying systemic pathology, this could be differentiated with blood tests for serum calcium, iPTH, along with other routine blood investigations. Moreover, basal ganglia calcification seen in CT scans could radiologically mimic the disease condition, thus clinical correlation with radiological investigations are the key in the diagnosis of Fahr's disease [2,4,5]. Here, we present a case of a 65-yearold male, with Fahr's syndrome secondary to hyperparathyroidism which initially mimicked as Parkinson's disease and later improved after starting the patient on vitamin D and calcium carbonate therapy.…”

“…

Fahr's disease or Fahr's syndrome is characterized by the calcification of basal ganglia and cerebral cortex, which is usually transmitted in an autosomal dominant manner. It is a rare neurological condition and most of the patients with the disease condition present with movement disorders, tremors, dyskinesia, and sometimes gait disturbances, cognitive impairment, speech disturbances, psychiatric changes such as mania, sensory changes or even pain [1][2][3] . Fahr's disease should be differentiated from Fahr's syndrome, which is usually secondary to underlying systemic pathology, this could be differentiated with blood tests for serum calcium, iPTH, along with other routine blood investigations.

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