Journal of Neurology

, Volume 263, Issue 9, pp 1876–1879 | Cite as

Extensive bilateral striopallidodentate calcinosis: a 50 years history of hypoparathyroidism presenting like a parkinsonian syndrome

  • G. Donzuso
  • G. Sciacca
  • A. Nicoletti
  • G. Mostile
  • F. Patti
  • M. ZappiaEmail author
Letter to the Editors

Dear Sirs,

Bilateral striopallidodentate calcinosis (BSPDC) is characterized by calcifications of striatum and dentate nuclei and could be present in asymptomatic individuals as well as in a variety of neurological and metabolic conditions [1]. Parathyroid abnormalities appears to be the most common definable etiology for calcification of subcortical nuclei [2], and parathyroid tissue damage is a frequent complication of thyroid surgery [3, 4]. Here, we present the case of a patient who had thyroid surgery and who developed parkinsonism related to BSPDC as a consequence of a postoperative hypoparathyroidism performed 50 years before.

A 75-year-old woman was admitted to our clinic because of a symptomatology with an onset 1 year before admission and characterized by gait disturbances, with instability and falls, generalized motor slowing and mild cognitive decline. She had no family history of neurological diseases and referred thyroidectomy about 50 years before. The patient had been...


Hypoparathyroidism Dentate Nucleus Calcinosis Hyperphosphatemia Parkinsonian Syndrome 
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Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standard

All human studies have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Supplementary material

Supplementary material 1 (WMV 60574 kb)


  1. 1.
    Manyam BV (2005) What is and what is not ‘Fahr’s disease’. Parkinsonism Relat Disord 11:73–80CrossRefPubMedGoogle Scholar
  2. 2.
    Manyam BV, Walters AS, Narla KR (2001) Bilateral striopallidodentate calcinosis: clinical characteristics of patients seen in a registry. Mov Disord 16:258–264CrossRefPubMedGoogle Scholar
  3. 3.
    Fauci AS (2008) Harrison’s principles of internal medicine. McGraw-Hill, New YorkGoogle Scholar
  4. 4.
    Zisimopoulou V, Siatouni A, Tsoukalos G, Tavernarakis A, Gatzonis S (2013) Extensive bilateral intracranial calcifications: a case of iatrogenic hypoparathyroidism. Case Rep Med 2013:932184PubMedPubMedCentralGoogle Scholar
  5. 5.
    Gagliardi M, Morelli M, Annesi G, Nicoletti G, Perrotta P, Pustorino G, Iannello G, Tarantino P, Gambardella A, Quattrone A (2015) A new SLC20A2 mutation identified in southern Italy family with primary familial braincalcification. Gene 568(1):109–111CrossRefPubMedGoogle Scholar
  6. 6.
    Lemos RR, Ramos EM, Legati A, Nicolas G, Jenkinson EM, Livingston JH, Crow YJ, Campion D, Coppola G, Oliveira JR (2015) Update and mutational analysis of SLC20A2: a major cause of primary familial brain calcification. Hum Mutat 36(5):489–495CrossRefPubMedGoogle Scholar
  7. 7.
    Goswami R, Sharma R, Sreenivas V, Gupta N, Ganapathy A, Das S (2012) Prevalence and progression of basal ganglia calcification and its pathogenic mechanism in patients with idiopathic hypoparathyroidism. Clin Endocrinol 77(2):200–206CrossRefGoogle Scholar
  8. 8.
    da Silva RJ, Pereira IC, Oliveira JR (2013) Analysis of gene expression pattern and neuroanatomical correlates for SLC20A2 (PiT-2) shows a molecular network with potential impact in idiopathic basal ganglia calcification (“Fahr’s disease”). J Mol Neurosci 50(2):280–283CrossRefPubMedGoogle Scholar
  9. 9.
    Rastogi R, Beauchamp NJ, Ladenson PW (2003) Calcification of the basal ganglia in chronic hypoparathyroidism. J Clin Endocrinol Metab 88(4):1476–1477CrossRefPubMedGoogle Scholar
  10. 10.
    Agarwal R, Lahiri D, Biswas A, Mukhopadhyay J, Maity P, Roy MK (2014) A rare cause of seizures, parkinsonian, and cerebellar signs: brain calcinosis secondary to thyroidectomy. N Am J Med Sci 6(10):540–542CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Tsai DR, Huang SH, Lin SH (2013) Bilateral striopallidodentate calcinosis secondary to postsurgical hypoparathyroidism. BMJ Case Rep 13:2013Google Scholar
  12. 12.
    Rizvi I, Ansari NA, Beg M, Shamim MD (2012) Widespread intracranial calcification, seizures and extrapyramidal manifestations in a case of hypoparathyroidism. N Am J Med Sci 4(8):369–372CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • G. Donzuso
    • 1
  • G. Sciacca
    • 1
  • A. Nicoletti
    • 1
  • G. Mostile
    • 1
  • F. Patti
    • 1
  • M. Zappia
    • 1
    Email author
  1. 1.Section Neuroscience, Department “GF Ingrassia”University of CataniaCataniaItaly

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