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Case Reports
. 2024 Jan 18;3(1):e166.
doi: 10.1002/pcn5.166. eCollection 2024 Mar.

Idiopathic basal ganglia calcification presenting with obsessive-compulsive symptoms: A case report

Daisuke Yoshioka  1 , Takehiko Yamanashi  1 , Kenta Taneda  2 , Takashi Matsukawa  3 , Kenta Orimo  3 , Masaaki Iwata  1
Affiliations
Case Reports

Idiopathic basal ganglia calcification presenting with obsessive-compulsive symptoms: A case report

Daisuke Yoshioka et al. PCN Rep. .

Abstract

Background: Idiopathic basal ganglia calcification (IBGC), also known as Farh's disease, is a rare neurodegenerative disorder characterized by calcification of the basal ganglia and other brain regions. This disease usually occurs in middle-aged patients and presents with various neurological and psychiatric symptoms. The exact prevalence is unknown; however, population genomic data analysis suggests a prevalence of at least 4.5/10,000 to 3.3/1000, indicating that the disease is more common than previously thought and remains underdiagnosed.

Case presentation: We report the case of a middle-aged Japanese man who attempted suicide twice because of obsessive-compulsive ideation caused by trivial triggers. The patient's psychiatric symptoms resolved relatively quickly after hospitalization, and imaging and genetic testing led to a diagnosis of IBGC.

Conclusion: This case report illustrates the importance of including IBGC in the differential diagnosis of psychiatric symptoms that initially develop in middle-aged patients.

Keywords: Fahr's disease; idiopathic basal ganglia calcification; obsessive‐compulsive symptoms.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Evidence of bilateral calcification of the basal ganglia, thalamus, and dentate nucleus on brain computed tomography scan.
Figure 2
Figure 2
(a) The brain computed tomography (CT) scan revealed symmetrical calcification in the basal ganglia, thalamus, and dentate nucleus, with the extent of calcification slightly larger than before. (b) T2‐star‐weighted magnetic resonance imaging showed calcification in the same areas as did the CT scan.
Figure 3
Figure 3
Fluid‐attenuated inversion recovery sequence brain magnetic resonance imaging showed no abnormal findings other than calcified lesions. Axial brain slices at the level of (a) pons, (b) hippocampus, (c) basal ganglia, (d) central part of lateral ventricle, and (e) central sulcus. (f) Dopamine transporter scan showed decreased in the bilateral putaminal specific binding ratios (4.43 and 4.22 for the right and left side, respectively).
See this image and copyright information in PMC

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