Epilepsy secondary to intracranial calcification cause by hypothyroidism and chronic hypocalcaemia: a case report
Epilepsia secundaria a calcificación intracraneal causada por hipotiroidismo e hipocalcemia crónica: reporte de un caso
Sherifa Ahmed Hamed
Abstract
Intracranial calcification is a rare complication of endocrine disorders, such as hypothyroidism. We present a case of a 37-year-old woman who had recurrent generalized tonic-clonic seizures since the age of 19 that were unresponsive to antiepileptic medications. Upon examination, cerebellar ataxia was observed. A brain CT scan and laboratory investigations conducted in April 2023 revealed extensive bilateral symmetric cerebral and cerebellar calcifications, hypothyroidism, hypocalcemia, hypophosphatemia, vitamin D deficiency, and normal levels of parathyroid hormone and kidney, and liver function tests. Antithyroid peroxidase antibodies were negative. The patient's brain calcifications, epilepsy, and ataxia were attributed to chronic hypocalcemia secondary to hypothyroidism and vitamin D deficiency. Treatment included levothyroxine, calcium, vitamin D supplements, and antiepileptic drugs (oxcarbazepine and levetiracetam). Over a year of follow-up, significant medical and neurological improvements were noted, with normalization of thyroid function tests and well-controlled seizures on medication. In conclusion, extensive intracranial calcification and recurrent seizures are uncommon complications of hypothyroidism, likely due to chronic hypocalcemia and hypovitaminosis D. Management involved long-term therapy with levothyroxine, calcium, vitamin D supplements, and antiepileptic drugs.
Keywords
Resumen
La calcificación intracraneal es una complicación poco frecuente de trastornos endocrinos, como el hipotiroidismo. Presentamos el caso de una mujer de 37 años que presentó convulsiones tónico-clónicas generalizadas recurrentes desde los 19 años, que no respondieron a la medicación antiepiléptica. En la exploración, se observó ataxia cerebelosa. Una tomografía computarizada cerebral y estudios de laboratorio realizados en abril de 2023 revelaron extensas calcificaciones cerebrales y cerebelosas simétricas bilaterales, hipotiroidismo, hipocalcemia, hipofosfatemia, deficiencia de vitamina D y niveles normales de hormona paratiroidea y pruebas de función renal y hepática. Los anticuerpos antiperoxidasa tiroidea fueron negativos. Las calcificaciones cerebrales, la epilepsia y la ataxia de la paciente se atribuyeron a hipocalcemia crónica secundaria al hipotiroidismo y a la deficiencia de vitamina D. El tratamiento incluyó levotiroxina, calcio, suplementos de vitamina D y fármacos antiepilépticos (oxcarbazepina y levetiracetam). Tras un año de seguimiento, se observaron mejoras médicas y neurológicas significativas, con normalización de las pruebas de función tiroidea y convulsiones bien controladas con medicación. En conclusión, la calcificación intracraneal extensa y las convulsiones recurrentes son complicaciones poco frecuentes del hipotiroidismo, probablemente debidas a la hipocalcemia crónica y la hipovitaminosis D. El tratamiento incluyó terapia a largo plazo con levotiroxina, calcio, suplementos de vitamina D y antiepilépticos.
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References
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Submitted date:
10/17/2025
Reviewed date:
02/11/2026
Accepted date:
02/17/2026
Publication date:
02/17/2026
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