Pseudohypoparathyroidism: A Rare Cause of Status Epilepticus

Abstract

Hypocalcemia can result in a variety of symptoms which include paresthesias, muscle spasms, cramps, tetany and circumoral numbness. Arrhythmias, heart failure and seizures constitute the serious symptoms arising from hypocalcemia. Seizures resulting from hypocalcemia are more common in the pediatric population. Although hypocalcemia can result from several causes, hypoparathyroidism and Vitamin D deficiency are most commonly encountered causes in clinical practice. Pseudohypoparathyroidism is a rare cause of hypocalcemia. We report a case of a young boy who presented to the emergency in status epilepticus with encephalopathy. ECG revealed prolonged QT interval which prompted further evaluation for a possible metabolic cause for this new onset status epilepticus. Routine laboratory investigations revealed hypocalcemia. A parathyroid pathology was suspected since phosphate level was elevated. Parathyroid hormone (PTH) levels were elevated suggesting PTH resistance pseudohypoparathyroidism which was diagnosed after exclusion of other causes of hypocalcemia and other acquired causes of PTH resistance. Patient was managed with intravenous calcium gluconate infusion, oral calcium supplementation, calcitriol and antiepileptic drugs.

Keywords

• hypocalcemia
• pseudohypoparathyroidism
• status epilepticus