Extensive Calcifications on Brain MRI in a case of Hypoparathyroidism

T1W MRI images showing symmetrical hyperintensities involving caudate nuclei, lentiform nuclei, thalami and dentate nuclei of cerebellum
SW Imaging MRI showing suppression in the same areas as above

16-year old presented with seizures of five years duration. Seizures were of generalized tonic-clonic type. He was earlier diagnosed to have hypoparathyroidism on the basis of low serum calcium and low PTH levels in blood.

MRI brain showed bilateral symmetrical calcifications involving caudate nucleus, globus pallidus, thalamus and dentate nucleus of cerebellum. Calcifications were hyperintense on T1W images and were suppressed on susceptibility weighted imaging. The cause of calcification is supposed to be elevated serum phosphate levels.

For seizures, he was started on sodium valproate. He remained seizure-free on that. For hypoparathyroidism, he was started on calcium supplements and active vitamin D. There was significant clinical improvement with medical treatment.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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