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Neonatal seizures: soothing a burning topic

Matthew D Thornton1, Lei Chen, Melissa L Langhan

  • 1From the Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, New Haven, CT.

Pediatric Emergency Care
|October 3, 2013
PubMed

Insights

Neonatal seizures can stem from maternal calcium carbonate overdose during pregnancy. This case highlights the critical need to question mothers about OTC medication use in infants with seizures.

Area of Science:

  • Pediatrics
  • Neonatology
  • Clinical Medicine

Background:

  • Neonatal seizures are a serious condition with diverse etiologies, necessitating prompt diagnosis and management to prevent morbidity and mortality.
  • Hypocalcemia is a significant, though often overlooked, cause of neonatal seizures.
  • Evaluating the maternal history, including medication use, is crucial in diagnosing neonatal conditions.

Observation:

  • A 6-day-old infant presented with seizure-like episodes.
  • The infant exhibited severe hypocalcemia, hypomagnesemia, low parathyroid hormone, and hyperphosphatemia.
  • The infant's mother reported excessive calcium carbonate intake during pregnancy.

Findings:

  • Maternal ingestion of high-dose calcium carbonate during pregnancy led to severe neonatal hypocalcemia and related metabolic derangements.
  • This specific etiology for neonatal seizures due to maternal calcium carbonate overconsumption is exceptionally rare, with limited prior reports.
  • The infant's symptoms resolved with appropriate medical management of hypocalcemia.

Implications:

  • Clinicians should consider maternal over-the-counter medication use, particularly calcium carbonate, as a potential cause of neonatal seizures.
  • Anticipatory guidance for pregnant women experiencing gastroesophageal reflux should include warnings about excessive calcium carbonate intake.
  • Early identification of maternal medication history can expedite diagnosis and treatment of neonatal seizures.

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