Spectrum of Etiologies of Hypocalcemic Seizures in Children Under Two Years of Age

Authors

  • Ahmad Omair Virk Department of Neurology, The Children's Hospital and the Institute of Child Health, Faisalabad, Pakistan
  • Saba Ghulam Nabi Department of Neurology, Children's Hospital, Faisalabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i11.2119

Keywords:

Spectrum; Etiologies; Hypocalcemic Seizures; Children

Abstract

There are many causes of afebrile seizures, including metabolic disturbances; among them, hypocalcemia is the most common. Seizures related to hypocalcemia in infants are a serious clinical concern because they carry the risk of adverse long-term neurological and developmental outcomes. Objective: To determine the spectrum of etiologies of hypocalcemic seizures in children under two years of age. Methods: The current cross-sectional study was conducted at the neurology department of the children's hospital Faisalabad. The study duration was 8 months from June 2022 to February 2023. The overall sample size in our study was 54, calculated by using the WHO sample size calculator. Clinical information was collected from medical records, including key demographic and clinical details, such as age, sex, and seizure characteristics (type and frequency). Data were entered and analyzed using SPSS version 24. Results: A total of 54 patients with hypocalcemic fits were enrolled in the current study. Of 54 patients, males were 34 (62.96%) and females 20 (37.04%). Based on types of fits, generalized fits were observed in 42 (77.78%) patients, while focal fits were observed in 12 (22.22%) patients. The different causes of hypocalcemic fits were observed in our study: hypomagnesemia was the primary cause in 15 (27.78%) patients, followed by vitamin D deficiency in 11 (20.37%) patients, and hypoparathyroidism in 10 (18.52%) patients. In comparison, in only one patient (1.85%), the cause of hypocalcemia was pseudo-hypoparathyroidism. Conclusion: Our study concludes that hypomagnesemia, hypoparathyroidism, and vitamin D deficiency are the major causes of hypocalcemic fits. The findings highlight the importance of early detection, targeted nutritional interventions, and regular monitoring of calcium metabolism to reduce the risk of long-term complications.

Downloads

Download data is not yet available.

References

Ganta A, Nelson A, Singer-Granick C, Khokhar A. Fever and seizure in an 11-month-old girl. Pediatr Rev. 2021;42(2):96-99. https://doi.org/10.1542/pir.2020-0047

Asadullah, Shaikh S, Farhat A, Amanullah, Memon S, Chohan MN. Frequency of hypocalcaemia among children (age 2–60 months) presenting with first episode of afebrile seizures: a cross-sectional study. J Pharm Res Int. 2021;33(60B):1063-1068. https://doi.org/10.9734/jpri/2021/v33i60b34714

Meesters K, Wassenberg T, Vanbesien J. Hypocalcemia as a cause of complex febrile seizures in a toddler. Case Rep Pediatr. 2021;2021:1-4. https://doi.org/10.1155/2021/1798741

Michels TC, Kelly KM. Parathyroid disorders. Am Fam Physician. 2013;88(4):249-257.

Hao D, Wen Z, Jankovic J. Genetics and molecular biology of brain calcification. Ageing Res Rev. 2015;22:20-38. https://doi.org/10.1016/j.arr.2015.04.004

Gambardella A, Labate A. The role of calcium channel mutations in human epilepsy. Prog Brain Res. 2014;213:87-96. https://doi.org/10.1016/B978-0-444-63326-2.00004-1

Wang G, et al. CaV3.2 calcium channels control NMDA receptor-mediated transmission: a new mechanism for absence epilepsy. Genes Dev. 2015;29(14):1535-1551. https://doi.org/10.1101/gad.260869.115

Teleanu RI, Sarman MA, Epure DA, Matei M, Roşca I, Roza E. Autosomal dominant hypocalcemia type 1 and neonatal focal seizures. Children (Basel). 2023;10(6):1011. https://doi.org/10.3390/children10061011

Abbasi AN, Ikram F, Zaman S, Nawaz SH, Hussain S, Shahid H. Calcium and magnesium levels in children with febrile seizures admitted in a tertiary care hospital. Pak Armed Forces Med J. 2023;73(5):1364.

Uzunhan TA, Kaçar A, Mısırlı Özdemir EM, Yapıcı O. First afebrile seizures: clinical and radiological view with emergent testing. Pediatr Int. 2022;64(1):e15089. https://doi.org/10.1111/ped.15089

Tiwari S, Adhikari KM, Dhingra S. Simple febrile seizures in toddlers: do they have low serum calcium levels? Indian J Child Health. 2021;8(3):119-121. https://doi.org/10.32677/ijch.2021.v08.i03.003

Radi A, Bakkali O, Kmari M, Ourrai A, Hassani A, Abilkassem R, et al. Neonatal hypocalcemic seizures: about a 41-day-old infant. Asian J Pediatr Res. 2020;3(4):9-14. https://doi.org/10.9734/ajpr/2020/v3i430133

Özçora GDK. Evaluation of neurological prognosis in children with hypocalcemic seizures due to vitamin D deficiency. South Clin Ist Euras. 2022;33(4):429-434.

Fayyaz J, Rehman A, Hamid A, Khursheed M, Zia N, Feroze A. Age related clinical manifestation of acute bacterial meningitis in children. J Pak Med Assoc. 2014;64(3):296.

Gowda VK, Kulhalli JP, Benakappa SN, Benakappa A. Etiological profile of afebrile seizures in infants in a tertiary care center from southern India. J Pediatr Neurosci. 2019;14(2):82. https://doi.org/10.4103/jpn.JPN_61_18

Behrman RE, Vaughan VC III. Nelson textbook of pediatrics. Philadelphia: WB Saunders; 1983.

Jones BL, Smith SM. Calcium-sensing receptor: a key target for extracellular calcium signaling in neurons. Front Physiol. 2016;7:116. https://doi.org/10.3389/fphys.2016.00116

Verma P. Incidence of hypocalcemia in infants with seizures. J Cardio Vascu Dis Res. 2022;13(8):76-81.

Naz I, Naeem HM, Ikram S, Naz M, Usman M, Rehman A. Hypocalcemia in children presenting with afebrile seizures. Pak J Med Health Sci. 2022;16(7):711-715.

Muzna A, Hafsa M, Khadija NH. Incidence and etiology of hypocalcemia in infants admitted with seizures at tertiary care hospital. INSIGHTS JHR. 2024;2(2):295-302.

Kumar J, Singh A. Prevalence of hypocalcemia in seizures in infancy: correspondence. Indian J Pediatr. 2019;86:103-104.

Kamate M, Sharma K, Patil V. Prevalence of hypocalcemia in seizures in infancy. Indian J Pediatr. 2018;85:307-308.

Downloads

Published

2025-11-30

How to Cite

Virk, A. O. ., & Nabi, S. G. . (2025). Spectrum of Etiologies of Hypocalcemic Seizures in Children Under Two Years of Age. Biological and Clinical Sciences Research Journal, 6(11), 78–81. https://doi.org/10.54112/bcsrj.v6i11.2119

Issue

Section

Original Research Articles