Status Epilepticus in Idiopathic Hypoparathyroidism

Acute hypocalcaemia which is seen in critically ill patients or which is caused by certain medications usually does not require specific treatment. But chronic hypocalcaemia which is caused by hypoparathyroidism is usually a symptomatic and requires treatment. A 50-years-old female presented in status epilepticus. She had muscle spasms, carpopedal spasms, facial grimacing and papillo-oedema. Her serum calcium and PTH levels were markedly decreased and her serum magnesium levels were normal. The CT scan of her head revealed calcifications in the brainstem, cerebellum, basal ganglia and the corona radiata and her ECG showed a prolonged QT interval. A diagnosis of chronic hypocalcaemia with hypoparathyroidism was made. The patient gradually responded to calcium infusions, anti-convulsants and supportive treatment. She was discharged in a satisfactory condition after 20 days on oral calcium supplementations and anti-convulsants. This case highlights the importance of the parathyroid hormone and calcium measurements in patients who present in status epilepticus.