{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T19:40:10Z","timestamp":1745782810839,"version":"3.40.4"},"reference-count":4,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,7,14]]},"abstract":"<jats:p>A 23-year-old male patient presented with cognitive decline and seizures. Examination revealed Chvostek's and Trousseau's signs. Investigations revealed hypocalcaemia, hyperphosphatemia and normal intact parathyroid hormone levels. Imaging showed calcifications in bilateral basal ganglia, thalamus and dentate nuclei. Interictal electroencephalogram showed theta range slowing of background activity and bilateral temporo-occipital, irregular, sharp and slow wave discharges, which accentuated during hyperventilation, photic stimulation and eye closure. Appearance of epileptiform discharges after eye closure, hyperventilation and photic stimulation may suggest presence of central neural hyperexcitability due to hypocalcaemia. These features may be an equivalent of peripheral neuromuscular hyperexcitability (Chvostek's and Trousseau's signs) that occurs in hypocalcaemia. The clinical and electroencephalographic features completely reversed with correction of serum calcium without antiepileptic medications. It is important for clinicians to recognise these reversible changes, as it can help to avoid misdiagnosis and long-term administration of antiepileptic becomes unnecessary.<\/jats:p>","DOI":"10.1136\/bcr-2017-220994","type":"journal-article","created":{"date-parts":[[2017,8,1]],"date-time":"2017-08-01T07:37:34Z","timestamp":1501573054000},"page":"bcr-2017-220994","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Reversible central neural hyperexcitability: an electroencephalographic clue to hypocalcaemia"],"prefix":"10.1136","volume":"2017","author":[{"given":"Bhagyadhan A","family":"Patel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul T","family":"Chakor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2781-8155","authenticated-orcid":false,"given":"Kaumil V","family":"Kothari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swaleha","family":"Nadaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,8,1]]},"reference":[{"key":"2025042712193870000_2017.jul31_1.bcr-2017-220994.1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/WNP.0b013e3182a73db9","article-title":"Electroencephalography of encephalopathy in patients with endocrine and metabolic disorders","volume":"30","author":"Faigle","year":"2013","journal-title":"J Clin Neurophysiol"},{"key":"2025042712193870000_2017.jul31_1.bcr-2017-220994.2","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1111\/j.1468-1331.2006.01287.x","article-title":"Hypoparathyroidism: a rare treatable cause of epilepsy - report of two cases","volume":"13","author":"Bindu","year":"2006","journal-title":"Eur J Neurol"},{"key":"2025042712193870000_2017.jul31_1.bcr-2017-220994.3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1177\/155005948101200306","article-title":"Parathyroid epilepsy with continuous EEG abnormality","volume":"12","author":"Nagashima","year":"1981","journal-title":"Clin Electroencephalogr"},{"key":"2025042712193870000_2017.jul31_1.bcr-2017-220994.4","doi-asserted-by":"crossref","unstructured":"Liu MJ , Jw L , Shi XY , et al . Epileptic seizure, as the first symptom of hypoparathyroidism in children, does not require antiepileptic drugs. Childs Nerv Syst 2016. [Epub ahead of print:\u00a012 Dec 2016].","DOI":"10.1007\/s00381-016-3264-2"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-220994","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T19:19:50Z","timestamp":1745781590000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-220994"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,1]]},"references-count":4,"alternative-id":["10.1136\/bcr-2017-220994"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-220994","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,8,1]]}}}