Hypoparathyroidism Revealed by Unsuccessful Anti-epileptic Therapy

TL;DR

A 13-year-old patient was misdiagnosed with epilepsy until hypoparathyroidism was discovered through blood tests, highlighting the need to check electrolyte levels in seizure cases.

Contribution

The case emphasizes the importance of serum phosphocalcic testing in diagnosing hypoparathyroidism in patients with unexplained seizures.

Findings

Unsuccessful anti-epileptic therapy led to the discovery of hypoparathyroidism in a 13-year-old patient.

Electrolyte imbalances, particularly hypocalcemia, were linked to seizure activity in this case.

Correct diagnosis was achieved through biological investigations, not initial neurological assessments.

Abstract

Pediatric hypoparathyroidism is an uncommon endocrine disease that can be either isolated or syndromic. It occurs when the secretion of parathormone is insufficient to maintain normal levels of ionized calcium. Patients with hypoparathyroidism can exhibit cerebral calcifications and metabolic disorders, and the severity of such features is inversely correlated with hypocalcemia.

We report a case of a 13-year-old patient who was initially diagnosed with epilepsy by another medical team two years before her admission to our hospital and who was subjected to oral valproate therapy. The anti-epileptic therapy proved to be unsuccessful even with increasing doses. The diagnosis was corrected when we performed adequate biological investigations. This case is underlying the importance of the electrolytes profile, especially the serum phosphocalcic test, in the management of patients with new onset or recurrent epileptic seizures.

Figures