INCIDENCE AND ETIOLOGY OF HYPOCALCEMIA IN INFANTS ADMITTED WITH SEIZURES AT TERTIARY CARE HOSPITAL

Abstract

Background: Hypocalcemia is a significant metabolic disturbance in infants and a recognized cause of seizures. The condition often arises from vitamin D deficiency, hypoparathyroidism, or critical illnesses, disrupting calcium homeostasis. Understanding the clinical and biochemical contributors to hypocalcemia-related seizures is essential for timely diagnosis and management to prevent long-term neurological complications.

Objective: This study aimed to evaluate the clinical characteristics, biochemical parameters, and associated factors in infants presenting with hypocalcemia-related seizures, focusing on vitamin D status, parathyroid hormone (PTH) levels, and seizure characteristics.

Methods: A cross-sectional study was conducted at a tertiary care hospital over one year. Data were retrospectively collected for infants aged 1 month to 1 year diagnosed with hypocalcemia (serum calcium <8 mg/dL) and presenting with seizures. Exclusion criteria included seizures due to other metabolic disturbances, such as hyponatremia and hypoglycemia. Clinical data, including seizure type and duration, maternal vitamin D status, and feeding practices, were analyzed. Biochemical parameters such as serum calcium, phosphorus, magnesium, vitamin D, and PTH levels were evaluated. Associations were determined using chi-square tests, with p<0.05 considered statistically significant.

Results: Among 54 infants, 57.4% were male, and 94.4% were term. Vitamin D deficiency was identified in 38.9% of cases, significantly associated with hypocalcemia (p=0.0001). Hypoparathyroidism was present in 7.4% of infants (p=0.004). Most seizures (85.2%) lasted under five minutes, with prolonged seizures showing a significant association with hypocalcemia (p=0.046). Serum calcium levels ranged from 5–7 mg/dL in 66.7% of infants, and 37% exhibited low magnesium levels. Maternal vitamin D status was unknown in 53.7% of cases, with 24.1% being deficient.

Conclusion: Hypocalcemia-related seizures in infants are primarily associated with vitamin D deficiency and abnormal PTH levels. Early diagnosis and intervention targeting these factors are crucial to improving outcomes and preventing recurrent seizures.