Cerebellar syndrome due to hypoparathyroidism

Ertas, Nalan Kayrak; Hanoğlu, Lütfü; Kırbaş, Dursun; Hatemi, H.

doi:10.1007/s004150050099

Cited by 10 publications

(4 citation statements)

References 5 publications

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“…A prevalência das calcificações dos gânglios da base no hipoparatireoidismo é desconhecida, e em levantamento da literatura não encontramos estudos capazes de determinar este dado. Embora consideradas pouco freqüentes, após o surgimento da tomografia axial computadorizada vários casos foram relatados (2,3,(5)(6)(7)(8)(9)(10)(11)(12)15,17,19,20). Forman e cols.…”

Section: Discussionunclassified

“…A apresentação clínica é variável, há pacientes assintomáticos cujas calcificações são achados casuais em exames de imagem, com sintomas decorrentes da hipocalcemia, como nestes 3 casos relatados, até quadros graves de síndromes neurológicas diversas. Os relatos mais freqüentes descrevem manifestações piramidais como parkinsonismo (4)(5)(6)(7)10,12,16), demência ou estados confusionais agudos (6,8,9,16,17) e quadros convulsivos (3,11,13,15,18,20). Como em nossa paciente do caso 1, há também outros relatos em que a sintomatologia neurológica seguiu-se a um longo período de tetanias latentes ou manifestas, cujo diagnóstico não havia sido feito até então (12,13,15,16).…”

Section: Discussionunclassified

“…O tratamento do hipoparatireoidismo com cálcio e vitamina D, restabelecendo a calcemia normal, propiciou a estabilização do quadro neurológico na maioria dos casos descritos (1,(3)(4)(5)(6)(7)(8)(10)(11)(12)(13)20), o que também pôde ser visto em nossas pacientes dos casos 1 e 2.…”

Section: Discussionunclassified

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Calcificações cerebrais por hipoparatireoidismo: considerações sobre o diagnóstico, longo tempo após a tireoidectomia

Júnior

Oliveira

Arantes

et al. 2006

Arq Bras Endocrinol Metab

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The diagnosis of hypoparathyroidism with neurological findings occurring years after thyroid surgery is considered to be rare. The authors describe 3 cases of hypoparathyroidism associated to brain calcifications diagnosed many years after partial thyroidectomy. Two patients were admitted to Emergency Services presenting with seizures, without a previous diagnosis of hypoparathyroidism. The diagnosis was suspected adding the biochemical analysis to the scar on the neck. The CT, which was performed more than 20 years after surgery, showed large cerebral calcifications in both cases. The third patient did not have neurological symptoms, but presented basal and cerebellar calcifications that were demonstrated in the CT. All patients were treated with calcium and vitamin D with great improvement of clinical status. Adding to a case published previously, we count 4 cases from the same region. Thyroidectomies were very common in this region poor in dietary iodide. Since the clinical follow up was inadequate, we suspect that undetected cases similar to these may exist in the present moment.

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Section: Discussionunclassified

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Calcificações cerebrais por hipoparatireoidismo: considerações sobre o diagnóstico, longo tempo após a tireoidectomia

Júnior

Oliveira

Arantes

et al. 2006

Arq Bras Endocrinol Metab

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“…Although accumulating evidence has highlighted the involvement of the cerebellum in cognitive function, studies exploring the potential role of the cerebellum in T2DM are relatively rare. A plausible reason is that the cerebellum is thought to be protected by hypoglycemia (Ertas et al, 1997) and may prevent damage from hyperglycemia (Heikkila et al, 2010), although such theories are being challenged by some recent studies. For example, it has been found that the density of cerebellar gray matter (Garcia-Casares et al, 2014) and blood flow (Dai et al, 2017) are decreased in patients with T2DM.…”

Section: Introductionmentioning

confidence: 99%

Altered Cerebellar-Cerebral Circuits in Patients With Type 2 Diabetes Mellitus

Zhang

Gao

et al. 2020

Front. Neurosci.

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The role of the cerebellum in type 2 diabetes mellitus (T2DM) has been receiving increased attention. However, the functional connectivity (FC) between the cerebellar subregions and the cerebral cortex has not been investigated in T2DM. Therefore, the purpose of this study was to investigate cerebellar-cerebral FC and the relationship between FC and clinical/cognitive variables in patients with T2DM. A total of 34 patients with T2DM and 30 healthy controls were recruited for this study to receive a neuropsychological assessment and undergo resting-state FC. We selected four subregions of the cerebellum (bilateral lobules IX, right and left Crus I/II, and left lobule VI) as regions of interest (ROIs) to examine the differences in cerebellar-cerebral circuits in patients with T2DM compared to healthy controls. Correlation analysis was performed to examine the relationship between FC and clinical/cognitive variables in the patients. Compared to healthy controls, patients with T2DM showed significantly decreased cerebellar-cerebral FC in the default-mode network (DMN), executive control network (ECN), and visuospatial network (VSN). In the T2DM group, the FC between the left cerebellar lobule VI and the right precuneus was negatively correlated with the Trail Making Test A (TMT-A) score (r = −0.430, P = 0.013), after a Bonferroni correction. In conclusion, patients with T2DM have altered FC between the cerebellar subregions and the cerebral networks involved in cognitive and emotional processing. This suggests that a range of cerebellar-cerebral circuits may be involved in the neuropathology of T2DM cognitive dysfunction.

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Endocrine Disorders

Manto

2021

Handbook of the Cerebellum and Cerebellar Disorders

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Cerebellum is vulnerable to hormonal disturbances. The main endocrine disorders associated with cerebellar ataxia are thyroid diseases. Both hypothyroidism and hyperthyroidism can induce cerebellar symptoms in children and in adults. In most instances, cerebellar deficits may be reversible with hormonal replacement. Patients with impaired parathyroid hormone signaling may also exhibit cerebellar ataxia, including hypoparathyroidism, pseudohypoparathyroidism, and hyperparathyroidism. Diabetes (diabetes mellitus or diabetes insipidus) may also be combined with cerebellar deficits, sometimes in a context of a complex metabolic inherited disorder. There may be no direct causal association between the endocrine disturbance and cerebellar deficits in this case. The workup of cerebellar ataxia of undetermined cause should include detailed hormonal investigations. In particular, thyrotropin hormone (TSH) and free T4 levels should be determined in all ataxic patients, followed by additional hormonal investigations if necessary.

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Cerebellar syndrome due to hypoparathyroidism

Cited by 10 publications

References 5 publications

Calcificações cerebrais por hipoparatireoidismo: considerações sobre o diagnóstico, longo tempo após a tireoidectomia

Calcificações cerebrais por hipoparatireoidismo: considerações sobre o diagnóstico, longo tempo após a tireoidectomia

Altered Cerebellar-Cerebral Circuits in Patients With Type 2 Diabetes Mellitus

Endocrine Disorders

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