title: Extreme startle and photomyoclonic response in severe hypocalcaemia.
abstract: We report the case of 62-year-old woman referred to our department because of a clinical suspicion of tonic-clonic seizures. Clinical examination revealed an exaggerated startle reflex, EEG showed a photomyoclonic response, and blood tests indicated severe hypocalcaemia. Additional clinical data, treatment strategies, and long-term follow-up visits were reported. The present report discusses the difficulties in distinguishing between epileptic and non-epileptic startles, and shows, for the first time, exaggerated startle reflex and extreme photomyoclonic response due to severe hypocalcaemia.
authors.affiliation: Epilepsy Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Moccia
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, United Kingdom.
authors.forename: Roberto
authors.initials: R
authors.lastname: Erro
authors.affiliation: Epilepsy Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy.
authors.forename: Elvira
authors.initials: E
authors.lastname: Nicolella
authors.affiliation: Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, "G Gaslini" Institute, Genoa, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Striano
authors.affiliation: Epilepsy Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Striano
mesh_terms: D004569:Electroencephalography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006996:Hypocalcemia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D013216:Reflex, Startle / Q000502:physiology*; D012640:Seizures / Q000188:drug therapy / Q000209:etiology*; D014741:Video Recording / Q000379:methods; D014882:Water-Electrolyte Balance / Q000502:physiology
keywords: hypocalcemia; photomyoclonic response; serum electrolyte; startle