A case of Fahr’s disease in a patient treated for Parkinson’s

Fahr’s disease (FD), also referred to as familial idiopathic basal ganglia calcification (FBGC) or bilateral striopallidodentate calcinosis (BSPDC), is a rare neurodegenerative disorder characterized by bilateral calcification of the basal ganglia and other brain regions. FD typically presents with a diverse range of clinical symptoms, including neuropsychiatric manifestations, movement disorders, and various neurological features. This article presents a case of a 71-year-old woman with a complex clinical history. She initially presented with symptoms of an anxious depressive disorder, which were followed by the development of gait disturbances, tremor, and sudden blindness in her right eye. Over time, these symptoms became associated with cognitive disturbances. Initially misdiagnosed as Parkinson’s disease, the patient was treated with levodopa-carbidopa, which led to medication-induced psychosis. Subsequent evaluation revealed brain calcification consistent with FD. The case illustrates the diagnostic challenges associated with FD, as it can mimic other neurodegenerative conditions, and emphasizes the importance of a comprehensive diagnostic approach. Additionally, it highlights the importance of recognizing and managing medication-induced side effects, particularly in elderly patients with multiple comorbidities.