Pseudohypoparathyroidism and Epilepsy: Diagnostic Value of Computerized Cranial Tomography

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Abstract
Computerized cranial tomograms (CCT) unexpectedly showed bilateral symmetrical calcifications in basal ganalia and frontal areas in 2 unrelated epileptic patients 12 and 13 yr of age. The patients presented a variety of seizures, some with focal features; these seizures were resistant to medication in the 1st case. Subsequent testing revealed hypocalcemia and other biochemical and radiologic pseudohypoparathyroidism features, despite absence of usual phenotypic features, tetanic symptoms and positive family history. The CCT scan may provide the 1st clue to an underlying hypocalcemic disorder in an epileptic patient even when the skull X-ray is normal. Early detection of this metabolic condition by CCT scanning allows specific treatment to restore serum Ca levels to normal, which usually eliminates seizures and favors optimal cerebral functioning. Serial CCT scanning also provides a useful means for following the intracerebral calcifications, which remained unchanged after 1 and 2 yr of normocalcemia in the 2 patients.

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