Tonic-Clonic Seizures in a Patient with Primary Hypoparathyroidism: A Case Report

Armelisasso, C; Vaccario, M. L.; Pontecorvi, Alfredo; Mazza, Salvatore

doi:10.1177/155005940403500209

Cited by 24 publications

(13 citation statements)

References 4 publications

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“…It may occur as an isolated entity or may be associated with the autoimmune polyendocrine syndrome type 1 encompassing thyroid disease, autoimmune hypoadrenalism and muco-cutaneous candidiasis. There are few case reports in literature of adults presenting with intractable seizures secondary to idiopathic hypoparathyroidism 2. Our patient had developed symptoms of hypoparathyroidism quite late in life.…”

Section: Discussionmentioning

confidence: 70%

Idiopathic hypoparathyroidism: an unusual cause of acute encephalopathy

Gupta¹,

Lehl

Sachdev

2011

Case Reports

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BACKGROUNDMiddle-aged adults presenting with intractable seizures primarily due to an endocrinological condition is distinctly uncommon in medical literature. There are only isolated case reports of adults presenting with seizures secondary to idiopathic hypoparathyroidism, although postsurgical hypoparathyroidism causing acute hypocalcemic seizures is a frequent clinical occurrence. Idiopathic hypoparathyroidism has distinct clinical, biochemical and radiological manifestations which are simple to recognise and the seizures amenable to treatment without routine use of antiepileptic drugs. CASE PRESENTATIONA 50-year-old man presented to the medicine emergency with recurrent seizures of 1 day duration, postictal confusion and altered sensorium. There was no history of fever, headache, head trauma or focal neurological defi cit. He had similar episodes of seizures since last 2 years for which he was prescribed phenytoin. However, despite being compliant, he continued to have frequent breakthrough seizures with a recent increase in their frequency. Relatives gave a history of increased irritability and decreased judgement. He was operated for bilateral cataract 5 years back. There was no neck surgery in the past. There was no family history of similar illness. Subsequent examination of this patient revealed dystrophic nails, brisk refl exes and focal dystonia of upper limbs. The Trousseau sign was positive. There was no evidence of oral candidiasis. Rest of the systemic examination was unremarkable.

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Section: Discussionmentioning

confidence: 70%

Idiopathic hypoparathyroidism: an unusual cause of acute encephalopathy

Gupta¹,

Lehl

Sachdev

2011

Case Reports

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“…also described occurrence of tonic clonic seizure in a 36-year-old male with hypoparathyroidism. [9] Garg et al . reported tonic clonic seizures in a female patient with hypoparathyroidism.…”

Section: Discussionmentioning

confidence: 99%

A rare cause of seizures, parkinsonian, and cerebellar signs: Brain calcinosis secondary to thyroidectomy

et al. 2014

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Context:Post-thyroidectomy hypoparathyroidism presenting with Parkinsonian features and seizures with extensive intracranial calcifications is uncommon. Acquired intracranial calcification that affects structures other than the basal ganglia is rare.Case Report:We report a case of a 45-year-old woman with a history of total thyroidectomy who presented with Parkinsonian features, cerebellar signs, and seizures. Brain imaging revealed extensive intracranial calcifications secondary to long-standing hypoparathyroidism. The patient was treated with intravenous (IV) calcium gluconate therapy and shifted to oral calcium and calcitriol therapy. Her symptoms improved markedly. At four months of follow up, the patient had not suffered another episode of seizure and was being gradually weaned off anti-Parkinsonian therapy.Conclusion:This case describes the rare finding of extensive intracranial calcifications in a case of iatrogenic hypoparathyroidism secondary to thyroidectomy with its wide array of features and its remarkable response to restoration of calcium levels to normal limits.

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“…described 2 cases of tonic clonic seizures occurring with hypoparathyroidism,[10] Armelisasso et al . also described occurrence of tonic clonic seizure in a 36 year old male with hypoparathyroidism,[11] Garg et al . reported tonic clonic seizures in a female patient with hypoparathyroidism,[7] Gupta et al .…”

Section: Discussionmentioning

confidence: 99%

Widespread Intracranial Calcification, Seizures and Extrapyramidal Manifestations in a Case of Hypoparathyroidism

et al. 2012

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Hypoparathyroidism can present with neurological complaints like seizures, parasthesias, depression, psychosis, extrapyramidal manifestations and features of raised intracranial pressure. Hypoparathyroidism and pseudohypoparathyroidism are the most common causes of pathological basal ganglia calcification. A 50 year male presented with generalized seizures and extrapyramidal features like tremors and rigidity. Investigations revealed that he had hypocalcemia, hyperphosphatemia and very low PTH levels, CT scan of head showed calcification of bilateral basal ganglia, cerebellum and subcortical white matter of frontal and parietal lobes. He showed remarkable recovery on restoration of normal serum calcium levels. Hypoparathyroidism should be kept in the differential diagnosis of patients presenting with seizures and extrapyramidal features.

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Tonic-Clonic Seizures in a Patient with Primary Hypoparathyroidism: A Case Report

Cited by 24 publications

References 4 publications

Idiopathic hypoparathyroidism: an unusual cause of acute encephalopathy

Idiopathic hypoparathyroidism: an unusual cause of acute encephalopathy

A rare cause of seizures, parkinsonian, and cerebellar signs: Brain calcinosis secondary to thyroidectomy

Widespread Intracranial Calcification, Seizures and Extrapyramidal Manifestations in a Case of Hypoparathyroidism

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