A case of cerebral calcification due to hypoparathyroidism admitted with complex partial seizures from

Kompleks parsiyel nöbetlerle başvuran hipoparatiroidizme bağlı serebral kalsifikasyon olgusu

Abstract

Several factors play a role in etiopathogenesis of cerebral calcifications. Bilateral, symmetrical calcifications are commonly seen in idiopathic, familial entity or secondary to disturbances of parathormone and calcium metabolism. In this article, a 16 year-bid male patient admitted with complex partial seizures presented with abnormal speech and stereotypical movements, automatism and behavior disturbances was reported. In his¬tory, he has also generalised tonic-clonic seizures in different intervals for two years. There was focal slowing on temporal and occipital regions on EEC Diffuse, symmetrical and dense calcifications were seen in basal ganglia, cerebral and cerebellar hemispheres on computerized tomography. Level of serum calcium and parat¬hormone. were low and level of serum phosphorus was elevated. The case was evaluated as hypoparathyro¬idism, so vitamine D and calcium treatment were started. Carbamazepin (600mg/day) was given for complex partial seizures. Seizure recurrence wasn 't observed at one year follow-up. Although patients with cerebral cal¬cifications may present with various symptoms, this case who presented complex partial seizures was found in¬teresting and reported.

Özet

Serebral kalsifikasyonlarinpatogenezin.de ce§itli faktorler rot oynamaktadir. Bilateral, simetrik kalsifikasyon-lar en sik idiopatik ailesel olarak veya kalsiyum ve parathormon metabolizmasindaki bozukluklarda gorulur. Bu makalede klinigimize davrant§ degigikligi, anlamsiz tekrarlayict konu§ma ve haraketler, otomatizmalarla §ekillenen kompleks parsiyel nobetlerle basvuran 16 ya§indaki erkek olgu sunuldu. Hastamn oykusunde iki yildan bu yana degisik arahklarla jeneralize tonik klonik nobetler de vardi. EEG'de her iki temporal ve oksipi-tal bolgelerde belirgin fokal yava§lama vavdi. Bilgisayarh beyin tomografisinde bazal ganglionlar, serebral ve serebellar hemisferlerde simetrik, yaygtn ve yogun kalsifikasyonlar goruldu. Serum kalsiyum ve parathormon dilzeyi du§uk, fosfor diizeyi yiiksekti. Olgu hipoparatiroidizm olarak degerlendirilerek D vttamini ve kalsiyum tedavisi ba§landi. Kompleks parsiyel nobetler icin 600 mg/gun karbamazepin verildi. Hastamn biryilhk taki-binde de ndbet tekran gozlenmedi.. Serebral kalsifikasyonlu hastalar gesitli norolojik tablolarla basvurabilmek-le birlikte, olgumuz kompleks parsiyel nobetle gelmesi nedeni He ilginc bulunarak sunuldu.