The clinical manifestation and long-term follow-up of two children with idiopathic hypoparathyroidism combined with epilepsy_Journal of Epilepsy

Authors：

LI Dan , SUN Na , LIU Yu ,  HUANG Shaoping

Department of Peadiatric, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an710004, China;

Corresponding author：

HUANG Shaoping, Email: zhengtu1127@163.com

Keywords：

Epilepsy; Idiopathic hypoparathyroidism; Anti-epileptic drugs

DOI：

10.7507/2096-0247.20180062

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ObjectivesTo explore if epilepsy and idiopathic hypoparathyroidism could be coexisted in one patient.MethodsCollected clinical data of two epilepsy children with idiopathic hypoparathyroidism from the Second Affiliated Hospital of Xi’an Jiaotong University in January 2009. We record the clinical material in detail. The follow-up of two cases is oven 9 years. The diagnosis of idiopathic hypothyroidism is mainly based on the typical history, hypocalcemia, hyperphosphatemia, and hypoparathyroid hormone concentrations. The CT scans show calcifications at the junction of the basal ganglia and cortex and medulla.ResultsDuring 9 years of follow-up, both cases had recurred of convulsions due to reduced use of anti-epileptic drugs under conditions of normal serum calcium and phosphorus levels. Spontaneous slow wave can be found during 24 hours of EEG monitoring in the awake or sleep period. They continue oral antiepileptic drugs.ConclutionsWe suggested that children with idiopathic hypoparathyroidism can be combined with epilepsy. And the mechanism may be related to abnormal intracranial calcification. In addition to calcium and active vitamin D, anti-epileptic drugs which have little effect on metabolism of calcium and phosphorus should be selected for treatment.

Citation： LI Dan, SUN Na, LIU Yu, HUANG Shaoping. The clinical manifestation and long-term follow-up of two children with idiopathic hypoparathyroidism combined with epilepsy. Journal of Epilepsy, 2018, 4(5): 381-386. doi: 10.7507/2096-0247.20180062 Copy

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4.	Brandi ML, Bilezikian JP, Shoback D, et al. Management of hypoparathyroidism: summary statement and guidelines. J Clin Endocrinol Metab, 2016, 101(6): 2273-2283.
5.	Modi S, Tripathi M, Saha S, et al. Seizures in patients with idiopathic hypoparathyroidism: effect of antiepileptic drug withdrawal on recurrence of seizures and serum calcium control. Eur J Endocrinol, 2014, 170(5): 777-783.
6.	Eom TH, Kim YH, Kim JM. Recurrent seizures, mental retardation and extensive brain calcinosis related to delayed diagnosis of hypoparathyroidism in an adolescent boy. J Clin Neurosci, 2015, 22(5): 894-896.
7.	Liu MJ, Li JW, Shi XY, et al. Epileptic seizure, as the first symptom of hypoparathyroidism in children, does not require antiepileptic drugs. Childs Nerv Syst, 2017, 33(2): 297-305.
8.	Hwang KJ, Kim J, Joo EY, et al. Intractable epilepsy with solitary cerebral calcification. J Epilepsy Res, 2017, 7(2): 126-128.
9.	Mahajan L, Malhotra HS, Garg RK, et al. Predictors of lesion calcification in patients with solitary cysticercus granulomaand new-onset seizures. Am J Trop Med Hyg, 2016, 95(3): 623-628.
10.	Kowacs PA, Rogacheski E, Muzzio J, et al. The role of the irritative zone and of the number and distribution of calcifications in the severity of epilepsy associated with intracranial calcifications. Arq Neuropsiquiatr, 2006, 64(4): 905-911.

1. Underbjerg L, Sikjaer T, Mosekilde L,et al. Cardiovascular and renal complications to postsurgical hypoparathyroidism: a danish nationwide controlled historic follow up study. J Bone Miner Res, 2013, 28(11): 2277-2285.
2. Clarke BL, Brown EM, Collins MT, et al. Epidemiology and diagnosis of hypoparathyroidism. J Clin Endocrinol Metab, 2016, 101(6): 2284-2299.
3. Shoback DM, Bilezikian JP, Costa AG, et al. Presentation of hypoparathyroidism: etiologies and clinical features. J Clin Endocrinol Metab, 2016, 101(6): 2300-2312.
4. Brandi ML, Bilezikian JP, Shoback D, et al. Management of hypoparathyroidism: summary statement and guidelines. J Clin Endocrinol Metab, 2016, 101(6): 2273-2283.
5. Modi S, Tripathi M, Saha S, et al. Seizures in patients with idiopathic hypoparathyroidism: effect of antiepileptic drug withdrawal on recurrence of seizures and serum calcium control. Eur J Endocrinol, 2014, 170(5): 777-783.
6. Eom TH, Kim YH, Kim JM. Recurrent seizures, mental retardation and extensive brain calcinosis related to delayed diagnosis of hypoparathyroidism in an adolescent boy. J Clin Neurosci, 2015, 22(5): 894-896.
7. Liu MJ, Li JW, Shi XY, et al. Epileptic seizure, as the first symptom of hypoparathyroidism in children, does not require antiepileptic drugs. Childs Nerv Syst, 2017, 33(2): 297-305.
8. Hwang KJ, Kim J, Joo EY, et al. Intractable epilepsy with solitary cerebral calcification. J Epilepsy Res, 2017, 7(2): 126-128.
9. Mahajan L, Malhotra HS, Garg RK, et al. Predictors of lesion calcification in patients with solitary cysticercus granulomaand new-onset seizures. Am J Trop Med Hyg, 2016, 95(3): 623-628.
10. Kowacs PA, Rogacheski E, Muzzio J, et al. The role of the irritative zone and of the number and distribution of calcifications in the severity of epilepsy associated with intracranial calcifications. Arq Neuropsiquiatr, 2006, 64(4): 905-911.

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The clinical manifestation and long-term follow-up of two children with idiopathic hypoparathyroidism combined with epilepsy

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