Primary hypoparathyroidism presenting as adult onset seizure: a report of two cases
T. Varma, R. Panchani, A. Saini, S. Tripathi, N. Gupta & S. Kumar
Introduction: Primary Hypoparathyroidism presents most commonly in childhood to early adolescence. Disease may be familial or sporadic.Most commonly hypoparathyroidism is secondary to neck operations especially Thyroid surgeries. Primary can be congenital eg- Digeorge syndrome or inherited by AD, AR or X linked mediated.We report 2 cases of late onset seizure due to Digeorge syndrome and Autosomal Dominant Hypoparathyroidism in a elderly lady.
Case Reports: Case 1
Twenty-seven year old female was brought with statue epilepticus and had hypocalcemia.CT Scan brain showed basal ganglia calcification.She also had mental retardation, cleft palate, posterior tongue tie and recurrent infections. Biochemical profile suggestive of severe hypocalcemia with bicytopenias. FISH for 22qdel11 was positive and diagnosis of Digeorge syndrome was made.
Case 2: Fifty-six year old lady presented with GTCS for first time. She was evaluated and found to have basal ganglia calcification and hypocalcemia.On evaluation her daughter and grand children also had asymptomatic hypocalcemia.
Conclusion: Chronic hypocalcemia may present with seizure, cognitive symptoms or psychiatry symptoms in most of the patients. All these symptoms show marked improvement with treatment. Prevalence of unrecognized Primary hypoparathyroidism in adults is very rare. It is important to evaluate serum calcium in all patients who present with new CNS symptoms.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.