Prevalence of Hypocalcemia Among Infants Presenting with Seizures: A Prospective Study

Background: Seizures are a common neurological emergency in infancy and may result from febrile illness, epilepsy, central nervous system infection, structural brain abnormalities, or metabolic disturbances. The objective is to determine the prevalence of hypocalcemia among infants presenting with seizures. Material and Methods: The Department of Paediatrics at the Navodaya Medical College Hospital and Research Center in Raichur was the site of this prospective observational study. A total of 100 infants aged 1 month to 2 years presenting with seizures were included. Infants with CNS infections, known congenital brain malformations, and those whose mothers were taking drugs or supplements affecting bone mineral metabolism were excluded. Results: Among 100 infants presenting with seizures, 27 (27.0%) were found to have hypocalcemic seizures, while 73 (73.0%) had non-hypocalcemic seizures. Hypocalcemia due to vitamin D deficiency accounted for 27.0% of all cases and was the second most common final diagnosis after typical febrile convulsions, which were observed in 31 (31.0%) infants. Other diagnoses included atypical febrile convulsions in 20 (20.0%), epilepsy in 18 (18.0%), hypomagnesemia in 6 (6.0%), and other electrolyte abnormalities in 2 (2.0%) infants. No cases of hypoparathyroidism, hypoglycemia, CNS infection, or inborn errors of metabolism were reported. Conclusion: Hypocalcemia was present in more than one-fourth of infants presenting with seizures, making it an important and treatable biochemical cause in this age group. Routine corrected serum calcium estimation should be included in the initial evaluation of infants with seizures, especially in settings where vitamin D deficiency is common.

Keywords: Hypocalcemia, Infant seizures, Infants, Neonatal hypocalcemia, Serum calcium, Acute symptomatic seizures, Prospective study, Pediatric neurology.