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一般认为慢性甲状旁腺机能减退的神经系统并发症为病性发作、智能障碍、锥体外系统体征和脑钙化等,其中以脑钙化,尤其是基底神经节钙化更多见。作者报道一例慢性甲状旁腺机能减退的病人,头颅CT扫描显示广泛性脑钙化,临床表现为进行性构音障碍和吞咽困难。患者,女性,81岁,因进行性构音障碍,吞咽困难、走路不稳和轻度精神异常18个月就诊。近6～8月以来,由于吞咽困难使体重减轻11～13公斤。13年前化验血钙为1.2mmol八,诊断为甲状旁腺机能减退,给予碳酸钙2500mg和二氢速甾醇(dihydrot-achysterol)0.125mg,每日两次。26年前开始全身性强直性阵挛性抽搐,用苯巴比妥治疗,15mg/d。
Neurological complications of chronic hypoparathyroidism are generally considered as onset of disease, mental retardation, extrapyramidal signs and brain calcification, among which cerebral calcification, especially basal ganglia calcification is more common. The authors report a patient with chronic hypoparathyroidism who underwent cranial computed tomography (CT) scans showing extensive brain calcification, with progressive dysarthria and dysphagia. Patient, female, 81 years old, 18 months due to progressive dysarthria, dysphagia, walking disorders and mild mental disorders. Nearly 6 to August, weight loss due to dysphagia 11 to 13 kg. Thirteen years ago, blood calcium was assayed at 1.2 mmol eight, diagnosed as hypoparathyroidism, administered with 2500 mg of calcium carbonate and 0.125 mg of dihydrot-achysterol twice daily. Twenty-six years ago, he started having generalized tonic clonic seizures treated with phenobarbital at 15 mg / day.