Agarwal Rakesh, Lahiri Durjoy, Biswas Amrita, Mukhopadhyay Jotideb, Maity Pranab, Roy Manoj Kumar
Department of General Medicine, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.
N Am J Med Sci. 2014 Oct;6(10):540-2. doi: 10.4103/1947-2714.143287.
Post-thyroidectomy hypoparathyroidism presenting with Parkinsonian features and seizures with extensive intracranial calcifications is uncommon. Acquired intracranial calcification that affects structures other than the basal ganglia is rare.
We report a case of a 45-year-old woman with a history of total thyroidectomy who presented with Parkinsonian features, cerebellar signs, and seizures. Brain imaging revealed extensive intracranial calcifications secondary to long-standing hypoparathyroidism. The patient was treated with intravenous (IV) calcium gluconate therapy and shifted to oral calcium and calcitriol therapy. Her symptoms improved markedly. At four months of follow up, the patient had not suffered another episode of seizure and was being gradually weaned off anti-Parkinsonian therapy.
This case describes the rare finding of extensive intracranial calcifications in a case of iatrogenic hypoparathyroidism secondary to thyroidectomy with its wide array of features and its remarkable response to restoration of calcium levels to normal limits.
甲状腺切除术后甲状旁腺功能减退伴帕金森样特征及癫痫发作并伴有广泛颅内钙化的情况并不常见。影响基底节以外结构的后天性颅内钙化很少见。
我们报告一例45岁女性,有甲状腺全切病史,出现帕金森样特征、小脑体征及癫痫发作。脑部影像学检查显示,长期甲状旁腺功能减退继发广泛颅内钙化。患者接受静脉注射葡萄糖酸钙治疗,之后改为口服钙剂和骨化三醇治疗。其症状明显改善。随访4个月时,患者未再发生癫痫发作,且正在逐渐减少抗帕金森治疗药物用量。
本病例描述了甲状腺切除术后医源性甲状旁腺功能减退患者罕见的广泛颅内钙化表现,伴有多种特征,且血钙水平恢复至正常范围后反应显著。