Neonatal convulsions associated with primary disturbance of calcium, phosphorus, and magnesium metabolism.

Abstract

Changes in the concentrations of calcium, phosphorus, and magnesium in the CSF mirrored those in the blood but were less pronounced.Osmolality in blood and CSF was the same in normal and in convulsing infants and there was no difference between these two groups of infants. There are wide differences in the osmolality of breast milk on one hand and most evaporated milk feeds on the other.In terms of associated neurological findings, infants suffering from convulsions due to a primary disturbance of mineral metabolism show a distinctive but not wholly exclusive clinical pattern.In therapy magnesium appears to have an important role in rectifying not only hypomagnesaemia but also hypocalcaemia.The prognosis in convulsions due to primary disturbance of mineral metabolism is good.Neonatal convulsions may result from a variety of causes including primary disturbance of mineral metabolism (Schwartz, 1965;McInerney and Schubert, 1969;Freeman, 1970;Rose and Lombroso, 1970). Material and methodsThe present study concerns 75 consecutive newborn infants seen over a two-year period with convulsions considered to be due primarily to disordered calcium phosphorus, or magnesium metabolism. Observed over the same period, and excluded from this report, were 60 infants with convulsions considered to be due primarily to brain damage in whom mineral metabolism was also frequently disturbed. The basis on which these two groups were differentiated has already been described (Brown, Cockburn, and Forfar, 1972).All the convulsing infants were fed on an evaporated milk formula. In order to obtain comparable normal biochemical values a group of 41 breast-fed infants were also studied on the 5th, 6th, and 7th days of life and a group of 60 artificially fed infants (fed the same evaporated milk formula as the convulsing infants) throughout the first week of life. The convulsing infants were examined at the time of the convulsion and several times thereafter until the biochemical results were normal.

Clinico-etiological profile of seizures in term and near-term neonates: tertiary care hospital based observational study

“…In the present study we found overall male sex preponderance in neonates who developed seizures which is similar to other studies like Cockburn et al, Fredrichsen, Mc intyre et al and Bagla et al [19][20][21][22] Reason for this sex preponderance is not explainable but may be attributed to some extent to male sex preponderance in our society as male babies are more cared for and immediate medical attention is given to them.…”

Serum Calcium Status of Neonates with Seizure in a Tertiary Care Hospital

“…Kumar et al 7 in a study showed that primary metabolic disorder accounted for 25% cause of neonatal convulsion. In a study which was carried out over 2 years period on neonatal convulsion by Cockburn et al 9 , it was found that 55% of neonatal convulsions were due to primary disturbances of mineral metabolism. Metabolic cause of convulsion is common in Bangladesh due to delayed and infrequent breast feeding, faulty feeding practices.…”

“…There is no evidence in the literature concerning the level of plasma calcium which defines neonatal hypocalcemia 9,10 . Some authors have defined neonatal hypocalcemia as plasma calcium level less than 8 mg/dl 9 , less than 7.5 mg/dl and less than 7 mg/dl 7 .…”

A Practical Approach to Emergencies in the Neonatal Period

“…Electrolyte disturbances are the most common etiology and include hypoglycemia, hypocalcemia, and hypomagnesemia [26]. Hypernatremia and hyponatremia can also produce seizures in the neonatal period but are less common.…”