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Multicenter Study
. 2017 Feb;33(2):297-305.
doi: 10.1007/s00381-016-3264-2. Epub 2016 Dec 12.

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

Meng-Jia Liu  1 , Jiu-Wei Li  2 , Xiu-Yu Shi  1 , Lin-Yan Hu  1 , Li-Ping Zou  3   4
Affiliations
Multicenter Study

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

Meng-Jia Liu et al. Childs Nerv Syst. 2017 Feb.

Abstract

Objective: Patients 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.

Method: This 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.

Result: A 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.

Conclusion: Thus, 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.

Keywords: Epilepsy; Hypocalcemia; Intracranial calcification; Parathyroid.

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Conflict of interest statement

Conflict of interest

We declare that there is no conflicts of interest.

Figures

Fig. 1
Fig. 1
Participant flow
Fig. 2
Fig. 2
Seizure outcome is not significantly different between the subjects with AED treatment and those without AED treatment, P = 0.34
Fig. 3
Fig. 3
The EEG results of a patient with pseudohypoparathyroidism before (a, b) and after (c, d) calcium supplement therapy. Before treatment, the EEG shows suspicious epileptic discharge characterized by spike wave and multiple spike waves. After treatment, the epileptic discharge is obviously ameliorated and the patient has reached seizure-free state
Fig. 4
Fig. 4
In the subjects with subcortical calcifications, seizure outcome is not significantly different in subjects with AED treatment and those without AED treatment, P = 0.38
Fig. 5
Fig. 5
Relationship among results of CT scan and EEG findings and type of seizures. No significant association was observed (a sites of calcifications × EEG, P value not available; b with or without subcortical calcifications × type of seizures, P = 0.477; c with or without frontal lobe calcifications × type of seizures, P = 0.648; d EEG findings × type of seizures, P = 0.732)
Fig. 6
Fig. 6
Seizure control outcomes in untreated patients with or without normalization of calcium
Fig. 7
Fig. 7
Intracranial calcifications in patients with poorly controlled calcium
See this image and copyright information in PMC

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