Department of Anesthesiology and Reanimation, Sakarya University Hospital, Adnan Menderes Cad. Sağlık Sok. No:195, 54100, Sakarya, Turkey.
Department of Pain, Sakarya University Hospital, Sakarya, Turkey.
Neurol Sci. 2020 Nov;41(11):3063-3065. doi: 10.1007/s10072-020-04733-7. Epub 2020 Sep 23.
Fahr's syndrome (or Fahr's disease) is a rare, neurological disorder characterized by bilateral calcification in the cerebellum, thalamus, basal ganglia, and cerebral cortex as a result of calcium and phosphorus metabolism disorder. The patients may be asymptomatic and clinical symptoms represent a wide range of neurologic manifestations and nonspecific neuropsychiatric disorders. We report an unusual case of Fahr's syndrome which was asymptomatic and incidentally diagnosed by generalized tonic-clonic seizure in a patient with SARS-CoV-2 (COVİD-19) pneumonia.
The patient was a 68-year-old female and admitted to our emergency department suffering from cough and fatigue. After thorax computed tomography (CT) and SARS-CoV-2 PCR test, she was diagnosed as COVID-19 pneumonia. In the intensive care unit, the patient had a tonic-clonic convulsion starting from the left arm and spreading to the whole body. Fahr's syndrome was diagnosed after a cranial CT scan and blood metabolic panel test.
As a result of the clinical, radiological, and biochemical evaluations, the patient was diagnosed incidentally as Fahr's syndrome associated with hypoparathyroidism. Seizures could be induced by hydroxychloroquine that was in the COVID-19 treatment or the inflammation caused by COVID-19 pneumonia. The association between the mortality of COVID-19 pneumonia and Fahr's syndrome is unknown which needs further research.
Fahr 综合征(或 Fahr 病)是一种罕见的神经紊乱疾病,其特征为钙和磷代谢紊乱导致小脑、丘脑、基底节和大脑皮层双侧钙化。患者可能无症状,临床症状表现为广泛的神经表现和非特异性神经精神障碍。我们报告了一例不典型 Fahr 综合征病例,该患者因 SARS-CoV-2(COVID-19)肺炎引起的全身性强直阵挛性发作而无症状和偶然诊断。
患者为 68 岁女性,因咳嗽和疲劳就诊于我院急诊。胸部 CT 和 SARS-CoV-2 PCR 检测后,诊断为 COVID-19 肺炎。在重症监护病房,患者出现从左臂开始并扩散到全身的强直阵挛性发作。头颅 CT 扫描和血液代谢谱检查后诊断为 Fahr 综合征。
通过临床、影像学和生化评估,患者被诊断为与甲状旁腺功能减退相关的 Fahr 综合征。COVID-19 治疗中使用的羟氯喹或 COVID-19 肺炎引起的炎症可能导致发作。COVID-19 肺炎与 Fahr 综合征之间的死亡率关联尚不清楚,需要进一步研究。