Clinal Analysis Of Epileptic Seizures As The Firsr Sign Epileptic Seizures As The First Sign Of Hypoparathyroidism

Objective: We were retrospectively analyzed of the clinical data of hypoparathyroidism with epileptic seizures as the first symptom,the progress of diagnosis and treatment is discussed to reduce misdiagnosis and missed diagnosis.Methods:The clinical data of hypoparathyroidism with Epileptic seizures were collected from January 2005 to December 2017 in the First Affiliated Hospital of Guangxi Medical University.Including the general conditions of the case,clinical manifestations,auxiliary examinations,and data on the treatment plan and retrospective analysis of the case,and combining the literature for discussion.Result:1.There were 7 cases of hypoparathyroidism with epilepsy-like appearance as the first manifestation,6 cases of female,1 case of male,including 5 cases of idiopathic hypoparathyroidism and 2 cases of pseudo-parathyroidism.The course of disease was from 1 month to 19 years.Age(34±14.17)years old.2.Clinical manifestations: 7 patients all had epilepsy as the first performance,6 cases of tetany;memory loss in 2 cases;hand,foot,perioral numbness in 1 case;skin changes in 1 case;7 cases have no round face,short neck,Albright hereditary osteodystrophy(AHO sign),such as short stature and metacarpal phalangeal malformations,positive facial nerve sniper slogs in 7 cases,and beam arm compression signs in 6 cases,no abnormalities in the neurological examination.3.Laboratory examination: 7 cases all showed low calcium and high phosphorus,low 24-hour urinary calcium,7 cases of blood calcium(1.08 ~ 1.62)mmol/L,serum phosphorus(1.84-3.05)mmol/L,24 h urinary calcium(0.43-2.09)mmol/24h;2 cases of PTH elevation(383.68-822.9)pg/ml,2 cases of PTH normal(10.31-63.75)pg/ml,3 cases of PTH decrease(<0.0-3.76)pg/ml;5 cases of 24 h urine Phosphorus was reduced(0.75-8.09)mmol/24 h,and 2 cases of 24 h urinary phosphorus were normal(11.74-31.3)mmol/24 h.7 cases of blood magnesium,alkaline phosphatase(ALP),creatinine were normal.In 4.6 routine cranial CT examinations,bilateral multiple symmetrical intracranial calcifications were seen.The lesions were distributed in 6 cases(100%)of basal ganglia calcification,2 cases(33.3%)calcification of frontal lobe,and 2 cases calcification of cerebellar hemisphere(33.3%).),calcification of the thalamus in 1 case(16.6%).Routine 5.3 eye lens examinations revealed cataracts in both eyes.6.6 routine electrocardiogram examination: 2 cases of normal,2 cases of T wave changes,1 case of QT interval prolongation,1 case of complete right bundle branch block.In 7.5 routine electroencephalogram examinations: one was normal;four were abnormal,manifested as: mild to moderate abnormalities in 2 cases,abnormal electroencephalography in 1 child,and moderate abnormality in 1 case.In 8.6 cases misdiagnosed as epilepsy,antiepileptic drugs were taken but the symptoms were not relieved.In 9.7 patients,the symptoms were improved after treatment with calcium and active vitamin D.Only one patient needed oral antiepileptic drugs.Conclusion:1.For new patients with epilepsy,attention should be paid to the improvement of serum calcium,phosphorus,PTH,and CT scans to exclude hypoparathyroidism in order to reduce misdiagnosis and missed diagnosis.2.Treatment of hypothyroidism complicated with epilepsy can be prevented or reduced by antiepileptic drugs after effective calcium supplementation and active vitamin D treatment.3.Hypoparathyroidism is currently no cure,calcium and active vitamin D may be the preferred treatment.