Open AccessFahr’s syndrome as a differential diagnosis amid parkinsonian syndromes: a case report
Author(s) -
Luana de Rezende Mikael,
Coralia Gabrielle Vieira Silveira,
Camilla Duarte Ribeiro,
Daniel Damiani,
Pedro Henrique de Lara Leite,
Helton Benevides Santana de Oliveira,
Danilo Donizete de Faria,
Roberta Arb Saba Rodrigues Pinto,
Sônia Maria Cesar de Azevedo Silva
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.465
Subject(s) - differential diagnosis , progressive supranuclear palsy , parkinsonism , basal ganglia , medicine , etiology , hypoparathyroidism , basal ganglia disease , pathology , context (archaeology) , atrophy , pediatrics , disease , surgery , central nervous system , biology , paleontology
Context: Parkinsonian syndromes are routinely identified by neurologists. However, the differential diagnosis among probable etiologies can be challenging and complex. In Fahr’s syndrome, calcifications of the basal ganglia secondary to disorders of calcium metabolism are observed. A possible clinical presentation associated with this entity is the presence of a parkinsonian syndrome. Case report: A 54-years-old female patient presented with a progressive tremor in the right upper and lower limbs associated with bradykinesia. Seizures were observed during the course of the disease. After extensive clinical workup, primary hypoparathyroidism was diagnosticated along with the recognition of a mutation in the calcium activator gene. Computed tomography and magnetic resonance imaging of the head showed bilateral coarse calcifications in thalami and basal ganglia compatible with Fahr’s syndrome. We began treatment for control of the underlying disease, as well as for symptomatic control of parkinsonism. Conclusions: Different pathologies could justify the parkinsonian syndrome observed initially in the case described. Among them: Iidiopathic Parkinson’s Disease, Multiple System Atrophy, Progressive Supranuclear Palsy. In our patient, the atypical evolution in a young woman led to the research of possible secondary treatable causes. A diagnosis of Fahr’s syndrome related to hypoparathyroidism was unveiled. The differential diagnosis of Parkinson’s Syndrome is broad and difficult. We must be aware of the possible atypical presentations due to the possibility of a secondary condition whose etiology could be effectively treated.