Neonatal seizures are a potentially life-threatening pediatric problem with a variety of causes, such as birth trauma, asphyxia, congenital anomalies, metabolic disturbances, infections, and drug withdrawal or intoxication. Thorough and timely evaluations of such patients are necessary to identify and treat the underlying etiology, therefore reducing potential morbidity and mortality. We review neonatal seizures and hypocalcemia and present the case of a 6-day-old male infant who presented to a tertiary pediatric emergency department with seizure-like episodes. He was found to have markedly low serum calcium, magnesium, and parathyroid hormone concentrations, as well as a significantly elevated serum phosphate concentration. The etiology of these abnormalities was found to be maternal ingestion of extremely high doses of calcium carbonate during the third trimester of her pregnancy, an occurrence that has been reported only once in the literature. Education pertaining to the dangers of excessive calcium carbonate intake during pregnancy may be an important piece of anticipatory guidance for pregnant mothers with symptoms of gastroesophageal reflux, and questioning the mother of a neonate presenting with seizures about such over-the-counter medications may help to elucidate the diagnosis.
From the Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
There was no honorarium, grant, or other form of payment given to anyone to produce this manuscript.
M.L.L. does receive funding for other unrelated research through CTSA grant UL1 RR024139 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH roadmap for Medical Research.
The other authors declare no conflict of interest.
The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official view of NCATS or NIH.
Reprints: Matthew D. Thornton, MD, 100 York Street, Suite 1F, New Haven, CT 06511 (e-mail: firstname.lastname@example.org).