Fahr's Syndrome in a Young Adult Male: A Case of Seizure and Cognitive Decline Secondary to Hypoparathyroidism.

Fahr's syndrome is a rare neurological condition characterized by bilateral intracranial calcifications secondary to metabolic or endocrine abnormalities, most commonly hypoparathyroidism. This condition is distinct from Fahr's disease (primary familial brain calcification), which is genetically inherited. A 30-year-old South Asian Pakistani man presented with sudden-onset generalized tonic-clonic seizures and progressive cognitive decline. Neuroimaging revealed bilateral, symmetrical calcifications in the basal ganglia, thalami, cerebellar dentate nuclei, periventricular regions, and centrum semiovale. Laboratory evaluation revealed severe hypocalcemia, hypomagnesemia, and markedly reduced parathyroid hormone levels, consistent with hypoparathyroidism. The patient was treated with calcium supplementation, calcitriol, vitamin D, magnesium replacement, and antiepileptic therapy, resulting in clinical stabilization of the patient. Fahr's syndrome should be considered in young patients presenting with seizures and cognitive impairment when characteristic intracranial calcifications are identified. Early recognition and correction of metabolic abnormalities can improve the outcomes.