Background

Fahr’s syndrome (or Fahr’s disease) is a rare, neurological disorder characterized by bilateral calcification in the cerebellum, thalamus, basal ganglia, and cerebral cortex as a result of calcium and phosphorus metabolism disorder. The patients may be asymptomatic and clinical symptoms represent a wide range of neurologic manifestations and nonspecific neuropsychiatric disorders. We report an unusual case of Fahr’s syndrome which was asymptomatic and incidentally diagnosed by generalized tonic-clonic seizure in a patient with SARS-CoV-2 (COVİD-19) pneumonia.

Case presentation

The patient was a 68-year-old female and admitted to our emergency department suffering from cough and fatigue. After thorax computed tomography (CT) and SARS-CoV-2 PCR test, she was diagnosed as COVID-19 pneumonia. In the intensive care unit, the patient had a tonic-clonic convulsion starting from the left arm and spreading to the whole body. Fahr’s syndrome was diagnosed after a cranial CT scan and blood metabolic panel test.

Conclusions

As a result of the clinical, radiological, and biochemical evaluations, the patient was diagnosed incidentally as Fahr’s syndrome associated with hypoparathyroidism. Seizures could be induced by hydroxychloroquine that was in the COVID-19 treatment or the inflammation caused by COVID-19 pneumonia. The association between the mortality of COVID-19 pneumonia and Fahr’s syndrome is unknown which needs further research.

中文翻译：

---

Fahr综合征伴有SARS-CoV-2（COVID-19）肺炎的癫痫发作-病例报告

背景

Fahr综合征（或Fahr病）是一种罕见的神经系统疾病，其特征是由于钙和磷代谢紊乱而导致小脑，丘脑，基底神经节和大脑皮质的双侧钙化。患者可能无症状，临床症状代表广泛的神经系统表现和非特异性神经精神疾病。我们报告了非典型的Fahr综合征病例，该病例无症状，由SARS-CoV-2（COVİD-19）肺炎患者的全身性强直阵挛性癫痫发作偶然诊断。

案例介绍

该患者为68岁的女性，因咳嗽和疲劳而入我们的急诊科。经过胸部计算机断层扫描（CT）和SARS-CoV-2 PCR测试后，她被诊断为COVID-19肺炎。在重症监护室，患者从左臂开始出现强直-阵挛性抽搐，并扩散到整个身体。经过颅脑CT扫描和血液代谢检查后，诊断为费氏综合症。

结论

通过临床，放射学和生化评估，该患者被误诊为伴甲状旁腺功能低下的费氏综合症。可能由COVID-19治疗中的羟氯喹或COVID-19肺炎引起的炎症引起癫痫发作。COVID-19肺炎的死亡率与Fahr综合征之间的关联尚不明确，需要进一步研究。