Generalized seizure in a 30-year-old man with presumed intracranial hemorrhage: A case report

A 30-year-old man presented to the emergency department of another institution with recurrent episodes of generalized tonic-clonic seizures. He was found to be hypocalcemic and was treated with an intravenous infusion of calcium followed by Dilantin. A computed tomography scan of the head was obtained, and the patient was transferred to our institution for neurosurgical evaluation and possible intervention of what was thought to be bilateral intracranial hemorrhages. After further evaluation at our institution, the diagnoses of hypoparathyroidism associated with hypocalcemic seizures and basal ganglia calcifications were established on both clinical and biochemical grounds. This case report discusses the clinical presentation, pathogenesis, diagnostic work-up, and management of hypoparathyroidism and associated seizures, highlighting the possible diagnostic and therapeutic pitfalls that are most pertinent to the emergency physician. (C) Elsevier Science Inc.