Fahr's disease in a patient with recurrent pneumonias, parkinsonism and dementia

BMJ Case Rep. 2024 Jan 31;17(1):e258470. doi: 10.1136/bcr-2023-258470.

Abstract

Fahr's disease is a rare condition characterised by the presence of idiopathic familial bilateral basal ganglia calcifications, transmitted in an autosomal-dominant fashion. Diagnosis is based on clinical features of neuropsychiatric and somatic symptoms in conjunction with radiological findings. Our patient, a man in his early 50s, presented with pneumonia. History was significant for five admissions in the last 2 years for pneumonia and falls, with gradual cognitive and motor decline since his late 30s. Hypophonia, bradykinesia and dementia were noted on examination. CT of the brain revealed bilateral thalamic calcinosis, consistent with Fahr's syndrome. Further investigations and retrospective history taking, and similar radiological findings within first-degree and second-degree relatives with early deaths, transitioned the diagnosis from Fahr's syndrome to Fahr's disease. We present this case of Fahr's disease to emphasise the value of collaboration among multidisciplinary professionals to improve quality of care for such patients.

Keywords: Chronic disease / disability nursing; Neuroimaging; Palliative care; Psychiatry; Radiology.

Publication types

  • Case Reports

MeSH terms

  • Basal Ganglia Diseases* / diagnosis
  • Basal Ganglia Diseases* / diagnostic imaging
  • Calcinosis* / diagnosis
  • Calcinosis* / diagnostic imaging
  • Dementia* / complications
  • Humans
  • Male
  • Neurodegenerative Diseases*
  • Parkinsonian Disorders* / diagnosis
  • Parkinsonian Disorders* / etiology
  • Pneumonia* / complications
  • Pneumonia* / diagnosis
  • Retrospective Studies

Supplementary concepts

  • Fahr's disease