title: [Seizures revealing phosphocalcic metabolism abnormalities].
abstract: Hypocalcemia due to hypoparathyroidism produces a broad spectrum of clinical manifestations, but overt symptoms may be sparse. One unusual presentation is onset or aggravation of epilepsy in adolescence revealing hypoparathyroidism. This situation can lead to delayed diagnosis, with inefficacity of the antiepileptic drugs. We report five cases of adolescence-onset epilepsy with unsuccessful antiepileptic therapy, even with gradually increasing dose. Physical examination revealed signs of hypocalcemia, confirmed biologically. Full testing disclosed the origin of the seizures: hypoparathyroidism in three patients and pseudohypoparathyroidism in the other two. In four of five patients, computed tomography showed calcification of the basal ganglia, defining Fahr's syndrome. The patients were treated with oral calcium and active vitamin D (1-alphahydroxy vitamin D3). Seizure frequency progressively decreased and serum calcium levels returned to normal. These cases illustrate the importance of the physical examination and of routine serum calcium assay in patients with new-onset epileptic seizures in order to detect hypocalcemia secondary to hypoparathyroidism.
authors.affiliation: Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc. Electronic address: fhmami@hotmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Hmami
authors.affiliation: Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc.
authors.forename: S
authors.initials: S
authors.lastname: Chaouki
authors.affiliation: Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc.
authors.forename: S
authors.initials: S
authors.lastname: Benmiloud
authors.affiliation: Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc.
authors.forename: F Z
authors.initials: FZ
authors.lastname: Souilmi
authors.affiliation: Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc.
authors.forename: S
authors.initials: S
authors.lastname: Abourazzak
authors.affiliation: Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc.
authors.forename: M
authors.initials: M
authors.lastname: Idrissi
authors.affiliation: Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc.
authors.forename: S
authors.initials: S
authors.lastname: Atmani
authors.affiliation: Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: Bouharrou
authors.affiliation: Service de pédiatrie, CHU Hassan II - Fès, B.P. 1835, Atlass, 30000 Fès, Maroc.
authors.forename: M
authors.initials: M
authors.lastname: Hida
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001480:Basal Ganglia Diseases / Q000097:blood / Q000209:etiology; D002114:Calcinosis / Q000097:blood / Q000209:etiology; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis*; D004830:Epilepsy, Tonic-Clonic / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000209:etiology* / Q000378:metabolism; D006996:Hypocalcemia / Q000378:metabolism*; D007011:Hypoparathyroidism / Q000150:complications / Q000151:congenital / Q000175:diagnosis*; D008297:Male; D011547:Pseudohypoparathyroidism / Q000150:complications / Q000175:diagnosis*; D014808:Vitamin D Deficiency / Q000209:etiology
chemical_list: D000927:Anticonvulsants
keywords: Crises épileptiques; Fahr syndrome; Hypocalcemia; Hypocalcémie; Hypoparathyroidism; Hypoparathyroïdie; Métabolisme phosphocalcique; Pseudohypoparathyroidism; Pseudohypoparathyroïdie; Seizures; Syndrome Fahr