{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T18:40:31Z","timestamp":1762195231427,"version":"build-2065373602"},"reference-count":20,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,10,4]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>A female infant presented with recurrent generalised tonic-clonic seizures, persistent upward gaze and a prolonged postictal phase. Clinical examination revealed macrocephaly and global developmental delay. Laboratory investigations demonstrated profound hypocalcaemia, with an ionised calcium level of 0.6\u2009mmol\/L, attributed to primary hypoparathyroidism. Neuroimaging via brain MRI identified an acute subdural haematoma characterised by a \u2018bat-wing\u2019 configuration along with bilateral diffusion restriction. Subsequent genetic analysis confirmed the diagnosis of glutaric aciduria type 1 (GA1). Initial management included urgent correction of hypocalcaemia, initiation of antiepileptic therapy, supportive measures, dietary adjustments tailored for GA1 and supplementation with L-carnitine. The patient\u2019s clinical status stabilised with resolution of seizures, and she was discharged with plans for continued metabolic and neurological follow-up. This case highlights the necessity of considering metabolic aetiologies, particularly hypocalcaemia secondary to hypoparathyroidism, as potential contributors to seizure activity in infants.<\/jats:p>","DOI":"10.1136\/bcr-2025-266341","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T10:10:42Z","timestamp":1761732642000},"page":"e266341","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Primary hypoparathyroidism as a seizure trigger in type 1 glutaric aciduria"],"prefix":"10.1136","volume":"18","author":[{"given":"Barath","family":"GR","sequence":"first","affiliation":[{"name":"General Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, 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