Acute Generalized Chorea, Dystonia and Brain Calcifications: A Case Report

Authors

  • Joana Ramos-Lopes Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Ana Brás Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Ana Morgadinho Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Fradique Moreira Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.

DOI:

https://doi.org/10.20344/amp.11026

Keywords:

Basal Ganglia Diseases, Calcinosis, Chorea, Dystonia, Hypocalcemia, Hypoparathyroidism

Abstract

Pathological basal ganglia calcification, or Fahr’s Syndrome, can be secondary to a variety of diseases, namely parathyroid disturbances. Movement disorders are common clinical features, in which chorea is seen in less than 20% of cases and dystonia just in 8%. We report the clinical case of a 49-year-old male with a history of thyroidectomy, who was admitted in Emergency Service with acute generalized chorea and focal painful feet dystonia. Laboratory analysis showed hypocalcemia and rhabdomyolysis, and computed tomography scan revealed parenchymal calcification with basal ganglia involvement. After complementary studies we established a Fahr’s Syndrome diagnosis secondary to an iatrogenic hypoparathyroidism. Clinical management has been successful with stabilized calcium levels, with no more neurologic symptoms. Hypocalcemia should be readily investigated and treated after a thyroidectomy, given the irreversibility of intracerebral calcifications and potential neurological or systemic consequences.

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Author Biographies

Joana Ramos-Lopes, Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.

Interna de Formação Específica de Neurologia do Centro Hospitalar e Universitário de Coimbra

Ana Brás, Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.

Interna de Formação Específica de Neurologia do Centro Hospitalar e Universitário de Coimbra

Ana Morgadinho, Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.

Serviço de Neurologia do Centro Hospitalar e Universitário de Coimbra

Fradique Moreira, Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.

Serviço de Neurologia do Centro Hospitalar e Universitário de Coimbra

Published

2019-05-31

How to Cite

1.
Ramos-Lopes J, Brás A, Morgadinho A, Moreira F. Acute Generalized Chorea, Dystonia and Brain Calcifications: A Case Report. Acta Med Port [Internet]. 2019 May 31 [cited 2024 Nov. 9];32(5):402-6. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11026

Issue

Section

Case Report