Significance of hypocalcaemia in neonatal convulsions

Abstract

The results are presented of a prospective study of 100 infants with generalized convulsions in the first 28 days of life. The cases occurred in a period of 23 months in two obsteric units in Manchester, an incidence of 8.6 per 1000 live births. In 37 infants no cause could be found for the convulsion; the commonest discovered cause was hypocalcaemia (level of under 7.5 mg./100ml.) which occurred alone in 34 infants, and was combined with hypoglycaemia in a further 4. In the hypocalcaemic group, 71% had the first fit between the 5th and 8th days of life; only 21% of the remaining 62 convulsing infants started in this period. All but 4 of the hypocalcaemic infants were artificially fed; feeding with an evaporated milk was nearly twice as frequent, and with a dried milk preparation only half as frequent as in the hospital population as a whole. In those infants followed up to a year not all of the group of infants with hypocalcaemia alone were neurologically normal. Hypocalcaemia in the first or second day of life presents a distinct clinical picture and has a different cause.