[Seizures revealing phosphocalcic metabolism abnormalities]
F Hmami1, S Chaouki1, S Benmiloud1
1Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc.
Revue Neurologique
|April 15, 2014
Summary
Hypoparathyroidism can cause epilepsy in adolescents, often missed by standard treatments. Early calcium level checks are crucial for diagnosing this condition and improving seizure control.
Area of Science:
- Neurology
- Endocrinology
- Metabolic Disorders
Background:
- Hypocalcemia, a common complication of hypoparathyroidism, presents with diverse clinical symptoms.
- Epilepsy onset or exacerbation in adolescence can be an atypical manifestation of hypoparathyroidism.
- Delayed diagnosis of hypoparathyroidism can result in ineffective antiepileptic drug (AED) treatment.
Observation:
- Five cases of adolescent-onset epilepsy with refractory symptoms to escalating AED doses were identified.
- Physical examination revealed hypocalcemic signs, confirmed by biological assays.
- Diagnostic workup identified hypoparathyroidism in three patients and pseudohypoparathyroidism in two.
- Brain CT scans showed basal ganglia calcification (Fahr's syndrome) in four patients.
Findings:
- Treatment with oral calcium and active vitamin D (1-alphahydroxy vitamin D3) normalized serum calcium levels.
- Seizure frequency significantly decreased in all treated patients.
- This highlights the link between hypocalcemia secondary to hypoparathyroidism and new-onset epilepsy.
Implications:
- Routine serum calcium testing is vital for adolescents presenting with new-onset epilepsy.
- Prompt identification of hypocalcemia can lead to effective treatment and improved epilepsy management.
- This underscores the importance of a thorough physical examination and biochemical screening in epilepsy diagnosis.
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