Background: Seizures are common in the neonatal period and may be the first sign of neonatal dysfunction. The incidence of neonatal seizures has been reported to be 1.5 to 3 in 1,000 full term live births.
Aim of the Work: To assess the levels of serum calcium and magnesium in neonates with neonatal convulsion.
Patients and Methods: The study includes 100 full term neonates with neonatal convulsions and 100 healthy full-term neonates as controls. Serum calcium, magnesium, sodium, potassium and random blood sugar and complete blood count were estimated in all neonates.
Results: There was significant decrease in total and ionized calcium and magnesium in convulsions group compared to control group (p<0.001, <0.001 & 0.015 respectively). There was a highly significant decrease in random blood sugar in convulsions group compared to control group (p<0.001). While there was no statistically obvious difference between the two groups regarding potassium and sodium level (p>0.05). Total calcium can detect convulsion at a cutoff 7.3 mg/dl with sensitivity, specificity, PPV and NPV was 31%, 100%, 100% and 59% respectively (p< 0.001). Also, Ionized calcium can detect convulsion at cutoff 4.1 mg/dl with sensitivity, specificity, PPV and NPV was 53%, 97%, 94.6% and 67.4% respectively (p< 0.001). Magnesium can detect convulsion at cutoff 1.3 mg/dl with sensitivity, specificity, PPV and NPV was 20%, 100%, 100% and 55.56% respectively (p=0.015). Random blood sugar can detect convulsion at cutoff 40 mg/dl with sensitivity, specificity, PPV and NPV was 41%,95%,89% and 61.7% respectively (p<0.001).
Conclusions: This study showed that hypoglycemia, hypocalcemia, and hypomagnesemia were significantly associated with neonatal seizures. A thorough biochemical work up is necessary in all cases of neonatal seizure for early detection and effective treatment of biochemical abnormalities in neonatal seizure.