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Neonatal seizures and familial hypomagnesemia with secondary hypocalcemia

Pongsakdi Visudhiphan1, Anannit Visudtibhan, Surang Chiemchanya

  • 1Department of Pediatrics, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.

Pediatric Neurology
|September 6, 2005
PubMed

Insights

Two siblings with hypomagnesemia and hypocalcemia experienced recurrent seizures. Prompt magnesium administration, not calcium, resolved their convulsions, highlighting the importance of correct diagnosis for normal development.

Area of Science:

  • Pediatric Endocrinology
  • Gastroenterology
  • Neurology

Background:

  • Hypomagnesemia with secondary hypocalcemia can present with severe neurological symptoms like seizures in neonates.
  • Accurate diagnosis is crucial as symptoms can mimic other conditions, leading to delayed or incorrect treatment.

Observation:

  • Two female siblings presented with recurrent generalized convulsions in early infancy.
  • Initial misdiagnosis as late-onset neonatal hypocalcemia occurred due to low serum calcium levels.
  • Seizures were refractory to initial calcium therapy but resolved completely with magnesium administration.

Findings:

  • The patients likely had a selective defect in intestinal magnesium absorption, causing hypomagnesemia.
  • Long-term oral magnesium supplementation was effective in managing the condition.
  • Both siblings achieved normal physical and mental development despite early seizure activity.

Implications:

  • This case underscores the critical need to consider and test for hypomagnesemia in infants with unexplained seizures, even with concurrent hypocalcemia.
  • Early and correct diagnosis of intestinal magnesium malabsorption is vital for preventing neurological sequelae.
  • Timely magnesium supplementation can lead to favorable long-term outcomes, including normal development.

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