- 期刊
A Rare Case of Seizure Attack in a Patient with Hypoparathyroidism
一個副甲狀腺功能低下症病人併發罕見的癲癇發作
摘要
癲癇是副甲狀腺功能低下症病人的其中一種神經學症狀。副甲狀腺功能低下症通常呈現慢性的低血鈣，而且癲癇在這些病人裡面並不常見。作爲一個癲癇的次發性原因，它常在一開始的檢查中被遺漏，因而延誤治療。廣泛性顱內鈣化，特別是發生在基底核這個部位，是副甲狀腺功能低下症一個很罕見的影像學發現，同時也提醒臨床醫師進一步評估病人。我們報告一位五十歲男性，以初次癲癇發作及廣泛性顱內鈣化爲表現。檢查結果發現低血鈣、高血磷及低副甲狀腺素。之後被診斷爲副甲狀腺功能低下症誘發的癲癇，這是因爲同時合併廣泛性顱內鈣化及低血鈣。這個病人的癲癇症狀在鈣補充劑及維生素D的治療下，獲得良好的控制。
並列摘要
Seizure is one of the neurological manifestations in patients with hypoparathyroidism. Hypoparathyroidism is usually associated with chronic hypocalcemia, and the occurrence of seizures is uncommon in patients with this metabolic condition. It is often overlooked as a secondary cause of epilepsy at the initial examination, which leads to delays in treatment. Extensive bilateral symmetric intracranial calcification, especially of the basal ganglia, is a rare finding in hypoparathyroidism; such findings should alert physicians to the possibility of this condition, and the patient should be examined further. We describe the case of a 50-year-old man who experienced his first episode of seizure and had extensive bilateral symmetric intracranial calcification. Investigations revealed hypocalcemia, hyperphosphatemia, and a low serum level of intact parathyroid hormone. Hypoparathyroidism-induced seizure was diagnosed and was attributed to the coexistence of extensive intracranial calcification and hypocalcemia. The seizure was brought under control with calcium and vitamin D supplements.