Hypoparathyroidism and Fahr's syndrome: case series

Fahr Syndrome: When Dysarthria Doesn't Mean a Stroke

Fahr syndrome is a rare neurodegenerative disorder, characterized by calcium deposition in the brain. It is usually associated with phosphocalcium metabolism disorders, like hypoparathyroidism, or with genetical predisposition, as seen in Fahr disease. Given the wide array of differential diagnoses medical awareness should be emphasized to prompt diagnosis and management. In this case, we depict a classical presentation of Fahr syndrome, highlighting the differential diagnosis with stroke given the similar clinical signs and symptoms, although pointing out the distinct radiological presentation that raises clinical suspicion for this entity.

Fahr's syndrome associated with hypoparathyroidism: A case report

Fahr's syndrome affects fewer than 1 in 100,000 people. It is an inherited neurological disorder, which is distinguished by atypical calcium deposition in the movement-controlling areas of brain, that is thalamus, dentate nucleus, basal ganglia, cerebellum, cerebral cortex, hippocampus and subcortical white matter. The majority of patients often experience extrapyramidal symptoms, cerebellar signs, speech difficulty, dementia and neuropsychiatric manifestations. This disease's molecular genetics have not been thoroughly investigated. Typically, young to middle-aged adults are affected though basal ganglia calcification in hypoparathyroidism is quite uncommon. Laboratory results and radiographic brain imaging helps in reaching the diagnosis. The treatment is mainly symptomatic. We present a case of Fahr's syndrome associated with hypoparathyroidism.

Fahr's syndrome with hypoparathyroidism, thrombocytopenia, and seizure: a rare case report

Fahr's syndrome, also known as bilateral striatopallidodentate calcinosis is a rare neurological disorder that is characterized by abnormal deposition of calcium in the basal ganglia, cerebellar dentate nuclei, and cerebral cortical white matter. The authors report an extremely uncommon case of Fahr's syndrome with thrombocytopenia, hypoparathyroidism, and seizure.

CASE PRESENTATION

A 32-year-old male was brought with a repeated history of twitching of hands, tingling sensation, and uncontrolled seizure despite medications.

CLINICAL DISCUSSION

Computed tomography findings showed bilateral basal ganglia, cerebellar dentate nuclei, and subcortical cerebral white matter calcifications. Laboratory studies revealed reduced levels of calcium, parathyroid hormone, and thrombocyte count. Based on these investigations Fahr's syndrome probably due to hypoparathyroidism with thrombocytopenia was diagnosed. The patient was initially treated with intravenous calcium gluconate and platelet transfusion followed by oral calcium supplementation.

CONCLUSION

Fahr's syndrome due to hypoparathyroidism should be suspected in any patient with neurological symptoms and hypocalcemia. Seizures in the patient of Fahr's syndrome with thrombocytopenia could be very detrimental due to the risk of intracranial hemorrhage. Hence, treatment should be started as early as possible.

Hypoparathyroidism and Fahr's Syndrome: A Case Series

Fahr's syndrome is defined by the presence of striato-pallido-dentate calcifications. It is a rare entity with clinical polymorphism, and it occurs in patients with dysparathyroidism, especially those with hypoparathyroidism. It must be distinguished from Fahr's disease (FD), which is defined by the presence of intracerebral calcifications without phosphocalcic metabolism abnormality. In this paper, we report the particulars of five patients diagnosed with Fahr's syndrome revealed by neurological and cognitive disorders, seizures, and abnormal movements associated with tetany crisis. In all cases, brain imaging and biological examinations led to the diagnosis of Fahr's syndrome related to hypoparathyroidism. The evolution was favorable after treatment. Fahr's syndrome is a rare and serious condition for which treatment is simple and effective. Our observations shed light on the necessity of evaluating phosphocalcic metabolism and exploring cerebral calcifications in patients with neurological disorders.

Seizures in activating calcium-sensing receptor antibodies positive autoimmune hypoparathyroidism and preponderance of steroids therapy: A case report

A 55-year-old female patient presented with generalized tonic-clonic seizures. Laboratory evaluation revealed low calcium (4.9 mg/dl), low PTH (0.9 pg/ml), and positive activating CaSR antibodies. The condition was diagnosed as autoimmune hypoparathyroidism. Calcium and vitamin D supplements did not correct the patient's hypocalcemia. The addition of prednisone to vitamin supplements showed a better response and corrected the hypocalcemia. The patient remained in seizure-free for one year.