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Osteomalacia presenting as chorea

D J Hosking, A Williams, R B Godwin-Austen

    British Medical Journal
    |July 19, 1975
    PubMed
    Summary
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    A 16-year-old epileptic experienced chorea due to vitamin D deficiency. This deficiency, causing osteomalacia and mineral imbalances, resulted from diet and anticonvulsant medications.

    Area of Science:

    • Neurology
    • Endocrinology
    • Nutritional Science

    Background:

    • Epilepsy is a neurological disorder often managed with anticonvulsant medications.
    • Vitamin D deficiency can lead to metabolic bone disease and neurological symptoms.
    • Chorea is a movement disorder characterized by involuntary, irregular muscle twitches.

    Purpose of the Study:

    • To investigate the underlying cause of chorea in a young epileptic patient.
    • To identify the relationship between anticonvulsant drug use, vitamin D deficiency, and secondary metabolic disturbances.

    Main Methods:

    • Case study of a 16-year-old male epileptic with chorea.
    • Biochemical analysis to assess calcium, phosphate, and vitamin D levels.
    • Review of medical history, including diet and medication use.

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    Main Results:

    • The patient presented with chorea, osteomalacia, hypocalcaemia, and hyperphosphataemia.
    • Laboratory findings confirmed severe vitamin D deficiency.
    • Hypoparathyroidism was ruled out as the cause of mineral imbalances.

    Conclusions:

    • Longstanding dietary deficiency and anticonvulsant drug administration were identified as the primary causes of vitamin D deficiency.
    • Vitamin D deficiency was the direct cause of the patient's osteomalacia and mineral imbalances, leading to chorea.