• Pediatric neurology · Jun 2013

    Case Reports

    Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion.

    • Jenna F Borkenhagen, Ellen L Connor, and Carl E Stafstrom.
    • University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53705, USA.
    • Pediatr. Neurol. 2013 Jun 1; 48 (6): 469-71.

    AbstractHypocalcemia is a common, treatable cause of neonatal seizures. A term girl neonate with no apparent risk factors developed seizures on day 5 of life, consisting of rhythmic twitching of all extremities in a migrating pattern. Physical examination was normal except for jitteriness. Laboratory evaluation was unremarkable except for decreased total and ionized serum calcium levels and an elevated serum phosphorus level. The mother had ingested 3-6 g of calcium carbonate daily during the final 4 months of pregnancy to control morning sickness. The baby's electroencephalogram showed multifocal interictal sharp waves and intermittent electrographic seizures consisting of focal spikes in the left hemisphere accompanied by rhythmic jerking of the right arm and leg. Treatment with intravenous calcium gluconate over several days resulted in cessation of seizures and normalization of serum calcium. The child has remained seizure free and is normal developmentally at 9 years of age. Hypocalcemic seizures in this newborn were likely secondary to excessive maternal calcium ingestion, which led to transient neonatal hypoparathyroidism and hypocalcemia. Inquiry about perinatal maternal medication use should include a search for over-the-counter agents that might not be thought of as "drugs," as in this case, antacids.Copyright © 2013 Elsevier Inc. All rights reserved.

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