Generalized seizure in a 30-year-old man with presumed intracranial hemorrhage: A case report

A 30-year-old man presented to the emergency department of another institut ion with recurrent episodes of generalized tonic-clonic seizures. He was fo und to be hypocalcemic and was treated with an intravenous infusion of calc ium followed by Dilantin, A computed tomography scan of the head was obtain ed, and the patient was transferred to our institution for neurosurgical ev aluation and possible intervention of what was thought to be bilateral intr acranial hemorrhages, After further evaluation at our institution, the diag noses of hypoparathyroidism associated with hypocalcemic seizures and basal ganglia calcifications were established on both clinical and biochemical g rounds. This case report discusses the clinical presentation, pathogenesis, diagnostic work-up, and management of hypoparathyroidism and associated se izures, highlighting the possible diagnostic and therapeutic pitfalls that are most pertinent to the emergency physician. (C) 2000 Elsevier Science In c.