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Basal ganglia calcifications and parkinsonism: insights from six fahr cases

Year: 2026

Type: article

Abstract: Objective : Basal ganglia calcifications are frequently incidental findings in older adults; however, when extensive and symptomatic, they may represent Fahr’s disease (FD) or Fahr’s syndrome (FS). Parkinsonism is a common yet underrecognized manifestation that may lead to misdiagnosis as idiopathic Parkinson’s disease. This study aimed to describe the clinical, laboratory, and radiological characteristics of patients with FD or FS presenting with parkinsonism and to evaluate their treatment responses. Methods : Six patients presenting with parkinsonian symptoms and diagnosed with FD or FS were retrospectively evaluated. Demographic features, neurological and psychiatric findings, laboratory parameters related to calcium–phosphorus metabolism, neuroimaging findings, treatment strategies, and clinical outcomes were analyzed. Disease severity was assessed using the Hoehn and Yahr staging system. All patients underwent brain computed tomography to determine the distribution and extent of intracranial calcifications. Results : All patients exhibited bilateral and symmetric basal ganglia calcifications, with additional involvement of the thalamus, cerebellum, or subcortical white matter in several cases. Two patients had familial disease consistent with FD, whereas four had secondary FS, most commonly associated with hypoparathyroidism following thyroidectomy, metabolic disorders, or infectious conditions. Parkinsonian features were present in all cases, and cognitive or neuropsychiatric symptoms accompanied motor findings in some patients. Levodopa therapy produced partial to moderate improvement in motor symptoms. In patients with hypoparathyroidism, calcium and vitamin D supplementation resulted in marked clinical improvement. Conclusion : FD and FS should be considered in the differential diagnosis of atypical or secondary parkinsonism, particularly in patients with symmetric basal ganglia calcifications. Early recognition improves outcomes.

Source: Brain Disorders

DOI: 10.1016/j.dscb.2026.100327

Author: Sinan Eliaçik

Institution: Hitit Üniversitesi

Language: English

Topic: Neurological diseases and metabolism

Subfield: Neurology

Field: Neuroscience

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,810