Seizure as a presenting manifestation of idiopathic hypoparathyroidism

A 31-year-old male presented with generalized new-onset tonic-clonic seizure related to severe hypocalcaemia [serum calcium 1.2 mmol/l] caused by idiopathic hypoparathyroidism [parathyroid hormone concentration 6pg; normal 15-65pg]. Computerized tomographic scan showed bilateral, symmetrical, intracranial calcifications involving the basal ganglia and the cerebellum. There are few reports in clinical literature describing new-onset seizure caused by primary hypoparathyroidism in adulthood and hypoparathyroidism needs to be considered in the differential diagnosis of adult-onset seizure

Double posterior communicating artery as a cause of oculomotor nerve palsy

Amongst clinicians the diagnostic approach differs to patients presenting with isolated third cranial nerve palsy. Some issues remain controversial and the management of this condition is a challenge. In a 38-year-old male presenting with pupil-involving oculomotor nerve palsy [internal dysfunction] the cause was found to be a double posterior communicating artery; a very rare cause of third nerve palsy