Fahr syndrome secondary tohypoparathyroidism post total thyroidectomy

Abstract

Objective: To report a clinical case of a hospitalized patient diagnosed with Fahr’s Syndrome.Case Presentation: A 70-year-old female patient with a history of hypothyroidism secondary to total thyroidectomy in 2003 and previously unrecognized iatrogenic hypoparathyroidism. She presented with atypical chest pain, dyspnea, and a generalized tonic-clonic seizure, followed by cognitive impairment, persecutory hallucinations, and psychomotor agitation. Laboratory investigations revealed severe and chronic hypocalcemia, while neuroimaging demonstrated bilateral and symmetrical intracranial calcifications, consistent with Fahr’s Syndrome. Management included calcium and active vitamin D (calcitriol) supplementation, with strict outpatient follow-up recommended. Final considerations: Fahr’s Syndrome, although rare, should be considered in patients with calcium metabolism disorders, particularly those with a history of post-surgical hypoparathyroidism. Early diagnosis and prompt correction of metabolic disturbances are crucial to preventing progressive neurological complications.