Epileptic seizure, as the first symptom of hypoparathyroidism in children, does not require antiepileptic drugs

Meng-Jia Liu,Xiu-Yu Shi,Jiu-Wei Li,Lin-Yan Hu,Li-Ping Zou

doi:10.1007/s00381-016-3264-2

Abstract

ObjectivePatients with hypoparathyroidism exhibit metabolic disorders (hypocalcemia) and brain structural abnormalities (brain calcifications). Currently, studies have determined whether antiepileptic drug (AED) treatment is required for epileptic seizures in children with hypoparathyroidism.MethodThis study aims to evaluate the data of two medical centers in Beijing based on the diagnosis of epileptic seizures as the first symptom of hypoparathyroidism in children.ResultA total of 42 patients were included and assigned into AED and non-AED treatment groups in a 1:2 matched case–control study. Results show that the seizure outcome after 1 year of AED treatment is not significantly different from that of the control. In the subgroup analysis of patients with subcortical calcifications, the seizure outcome is still not significantly different from that of the control.ConclusionThus, AED treatment cannot improve the seizure outcomes in children with parathyroid disorder, even in such cases as suspected structural seizure caused by subcortical calcifications. Clinicians must take adequate considerations on the use of AEDs in these patients. Epileptic seizures, as the first symptom of hypoparathyroidism in children, do not require epilepsy drugs.

Highlights

Epileptic seizure occurs when a burst of electrical impulses in the brain exceeds the normal limits
Parathyroid disorders are usually accompanied by intracranial calcifications, which occur in 21.5 to 73 % of patients with hypoparathyroidism; these observations are recognized as long-term complications of hypocalcemia [2]
We retrospectively reviewed 42 patients diagnosed with parathyroid disorders who exhibited epileptic seizure as a first symptom

Summary

Introduction

Epileptic seizure occurs when a burst of electrical impulses in the brain exceeds the normal limits. Its manifestation can vary from uncontrolled jerking movement (tonic–clonic seizure) to momentary loss of awareness (absence seizure) These impulses spread to adjacent areas in the brain and create an uncontrolled storm of electrical activity. Hypocalcemia can lead to reduced excitatory threshold, increased neural transmission, and increased neuromuscular excitation [3] This condition can lead to the increased susceptibility of hippocampal neurons to epilepsy and can impair the cerebral function through encephaledema, increased intracranial pressure, and metabolic disorder [4]. In this case, a sole treatment with antiepileptic drugs (AEDs) is insufficient.

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