Rashid Khan Zaraq, Waheed Waqar, Mabood Jawad, Ali Asim, Burki Gulalai
Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Internal Medicine, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, PAK.
Cureus. 2021 Jun 30;13(6):e16063. doi: 10.7759/cureus.16063. eCollection 2021 Jun.
Fahr's syndrome is a rare condition characterized by deposition of bilateral symmetric calcium deposits in the basal ganglia and cerebellar region, leading to neurological and psychiatric sequelae. Herein we describe a case of a 62-year-old female presented with aphasia, bilateral lower limb rigidity, tremors, and gait disturbance. Her past medical history included thyroidectomy and radiation therapy 10 years back due to papillary carcinoma of the thyroid gland. On examination, she had poor speech, resting tremor, walking difficulty, and decreased power in all limbs with rigidity. Her Chvostek and Trousseau signs were positive. Serum investigations revealed hypocalcemia and low levels of parathyroid hormone and thyroid-stimulating hormone. Brain magnetic resonance imaging revealed calcified lesions in basal ganglia, thalami, and dentate nuclei. She was diagnosed with Fahr's syndrome due to hypoparathyroidism, and she was managed with calcium gluconate, vitamin D, salt-free albumin, and levodopa-carbidopa, improving her condition. The patient was then discharged on calcium gluconate, calcitriol, recombinant parathyroid hormone, and levodopa-carbidopa with follow-up.
法尔氏综合征是一种罕见病症,其特征为双侧对称的钙沉积于基底神经节和小脑区域,从而导致神经和精神方面的后遗症。在此,我们描述一例62岁女性病例,该患者出现失语、双侧下肢僵硬、震颤及步态障碍。她的既往病史包括10年前因甲状腺乳头状癌接受甲状腺切除术及放射治疗。检查时,她存在言语不清、静止性震颤、行走困难,且四肢肌力下降伴僵硬。她的Chvostek征和Trousseau征呈阳性。血清检查显示低钙血症以及甲状旁腺激素和促甲状腺激素水平低下。脑部磁共振成像显示基底神经节、丘脑和齿状核有钙化病变。她因甲状旁腺功能减退被诊断为法尔氏综合征,并接受葡萄糖酸钙、维生素D、无盐白蛋白和左旋多巴 - 卡比多巴治疗,病情有所改善。随后患者出院时带药葡萄糖酸钙、骨化三醇、重组甲状旁腺激素和左旋多巴 - 卡比多巴,并进行随访。