The Journal of the Association of Physicians of India · 2025
Unveiling the Psychiatric and Neurological Manifestations of Idiopathic Hypoparathyroidism: A Case of Auditory Hallucinations and Seizure Disorder.
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Shaikh Juber D, Singh Ranjeet K
Аннотация
BACKGROUND: Idiopathic hypoparathyroidism (IHP) is a rare endocrine disorder characterized by hypocalcemia, leading to a diverse array of neurological and psychiatric manifestations. The emergence of psychiatric symptoms, particularly those that mirror primary psychiatric disorders, creates considerable difficulties in achieving a precise diagnosis and effective treatment.
CASE DESCRIPTION: A 35-year-old female patient was admitted with status epilepticus and a documented history of psychiatric illness. Initial investigations revealed hypocalcemia, hypomagnesemia, and hyperphosphatemia. A noncontrast computed tomography (CT) scan of the head showed striopallidodentate calcification, a characteristic finding in hypoparathyroidism. The patient reported persistent auditory hallucinations for the past 3 years, which were unresponsive to antipsychotic treatment. Additionally, she had a very low serum parathyroid hormone (PTH) level. Notably, the patient had no history of neck surgery, autoimmune disorders, cancers, radiation therapy, or infiltrative disorders such as hemochromatosis. There were no other congenital abnormalities or family history of similar illnesses. A diagnosis of IHP was established based on the patient's clinical symptoms and the results of the investigations. Calcium and magnesium supplements were started to correct the deficiencies of hypocalcemia and hypomagnesemia. Antiepileptic drugs were administered to control seizures. Despite the normalization of serum calcium levels, the patient's auditory hallucinations persisted, indicating a possible need for alternative therapeutic approaches.
CONCLUSION: This report emphasizes the need to consider IHP when diagnosing patients who present with ongoing psychiatric symptoms and seizures. The persistence of auditory hallucinations despite corrected hypocalcemia highlights the complexity of managing psychiatric manifestations in IHP. Early recognition and appropriate management of hypocalcemia are crucial for improving patient outcomes, although some psychiatric symptoms may remain refractory to conventional treatments.
CASE DESCRIPTION: A 35-year-old female patient was admitted with status epilepticus and a documented history of psychiatric illness. Initial investigations revealed hypocalcemia, hypomagnesemia, and hyperphosphatemia. A noncontrast computed tomography (CT) scan of the head showed striopallidodentate calcification, a characteristic finding in hypoparathyroidism. The patient reported persistent auditory hallucinations for the past 3 years, which were unresponsive to antipsychotic treatment. Additionally, she had a very low serum parathyroid hormone (PTH) level. Notably, the patient had no history of neck surgery, autoimmune disorders, cancers, radiation therapy, or infiltrative disorders such as hemochromatosis. There were no other congenital abnormalities or family history of similar illnesses. A diagnosis of IHP was established based on the patient's clinical symptoms and the results of the investigations. Calcium and magnesium supplements were started to correct the deficiencies of hypocalcemia and hypomagnesemia. Antiepileptic drugs were administered to control seizures. Despite the normalization of serum calcium levels, the patient's auditory hallucinations persisted, indicating a possible need for alternative therapeutic approaches.
CONCLUSION: This report emphasizes the need to consider IHP when diagnosing patients who present with ongoing psychiatric symptoms and seizures. The persistence of auditory hallucinations despite corrected hypocalcemia highlights the complexity of managing psychiatric manifestations in IHP. Early recognition and appropriate management of hypocalcemia are crucial for improving patient outcomes, although some psychiatric symptoms may remain refractory to conventional treatments.