Frequency of Hypocalcemia in Children Aged Less Than Two Years Presenting with First Afebrile Seizure

Abstract

Background: Afebrile seizures in small children are a frequent reason for hospital visits, and the exact cause is not always obvious at the time of presentation. In many cases, metabolic problems may contribute, and low calcium levels are one of the issues that can trigger seizures. This is particularly relevant in settings where nutritional intake is often inadequate and children may be more prone to deficiencies. Knowing how often hypocalcemia is present in young children with their first afebrile seizure can help clinicians decide which investigations are necessary and which treatments should be given early. Methodology: This descriptive cross-sectional study was carried out in the Department of Pediatrics at Hayatabad Medical Complex, Peshawar for the duration of six months, from August 2024 to January 2025. A total of 130 children between 2 and 24 months of age who presented with their first afebrile seizure were included through consecutive sampling after obtaining ethical approval. Clinical information was recorded, and a venous blood sample (2 mL) was taken to check serum calcium. Hypocalcemia was defined as a calcium level below 8 mg/dL. Data were entered and analyzed using SPSS version 22. Quantitative variables were summarized as mean and standard deviation, while categorical variables were presented as frequencies and percentages. Chi-square or Fisher’s exact test was used where appropriate, with a p-value of 0.05 taken as significant. Results: A high proportion of the children, about 68.5%, were found to have hypocalcemia. The trend was more noticeable in younger infants and those belonging to lower socioeconomic households. Children who had seizures lasting longer than a few minutes also showed a greater likelihood of having low calcium levels. Although not all associations reached statistical significance, the overall pattern suggested that calcium deficiency may play an important role in the presentation of afebrile seizures in this age group. Conclusion: The study shows that hypocalcemia is quite common among children under two years who come with a first episode of afebrile seizure. Checking serum calcium at the time of presentation may help in early management, reduce the duration or severity of seizures, and prevent unnecessary investigations, particularly in hospitals where resources are limited.