Fahr’s Disease Presenting with Manic Symptoms

Abstract

Bilateral striopallidodentate calcinosis (BSPDC), commonly known as Fahr’s disease, is a rare syndrome characterised by symmetrical calcification over the basal ganglion and dentate nucleus. No case of Fahr's disease with associated manic symptoms has been described in the literature to date. We report an unusual case of Fahr’s Disease in a 18 year old unmarried male who presented to the emergency department of Universal College of Medical Sciences – Teaching Hospital, Nepal with symptoms of mania. This rare case of Fahr’s disease has been reported to highlight this unusual condition and its differentiation from the commoner Fahr’s syndrome.

The use of quetiapine in treatment of acute psychotic symptoms in an adolescent patient with primary brain calcification: a case report

“…Even though there are other cases of affected adolescents found in the literature, for example an eighteen-year-old with manic symptoms [6] and a seventeen-year-old with catatonia associated with comorbid bipolar affective disorder [7], our case presented primarily with psychotic symptoms at a similar age. This shows that the disease may not be as rare in adolescence as previously believed and is becoming more frequently diagnosed due to the increased use of neuroimaging even in younger patients.…”

Síndrome de Fahr após tireoidectomia: relato de caso

“…Although there is still no consensus established in the literature regarding the conceptualization, the term Fahr Syndrome seems to be related to neuropsychiatric manifestations associated with calcifications of the basal nuclei due to changes in the functioning of the parathyroid glands and, consequently, to the reduction in serum calcium, while that Fahr's disease is related to idiopathic calcifications of the basal ganglia, accompanied by neurological signs without a previously defined cause 2,4,6 .…”

“…F ahr's syndrome is a rare neuropsychiatric disorder characterized by bilateral symmetrical calcification of the basal cerebral nuclei and dentate nuclei of the cerebellum, secondary to inflammatory, infectious diseases, exposure to toxins and radiation, but mainly due to metabolic disorders of calcium and phosphorus as occurs in hypoparathyroidism and pseudohypoparathyroidism 1,2,3,4 .…”

Basal Ganglia Calcification: A Case Report of Fahr Disease With Pure Psychiatric Symptoms

“…CT scan of that patient's head demonstrated extensive symmetrical calcification over the basal ganglia and dentate nuclei. 6 The rare case presented by Subedi and colleagues highlights the variety of signs and symptoms that may be associated with Fahr disease and emphasizes the important role of neuroimaging in patients with psychopathology as well as the need for adequate clinical and laboratory testing.…”

“…1 Case reports have suggested that haloperidol, sodium valproate, or lithium carbonate may help patients with psychotic symptoms. 6,7 However, currently available drugs are either insufficiently effective and/or have tolerance problems, 5 and the efficacy of psychopharmacologic interventions in Fahr disease remains to be defined.…”