Role of Serum Calcium, Magnesium, Phosphorus, and Vitamin D in Children with Febrile Seizures: A Case-Control Study

Abstract

Background: Febrile seizures, the most common paediatric seizure type, are associated with metabolic changes, including electrolyte imbalances and vitamin D deficiency. This study evaluates serum calcium, magnesium, phosphorus, and vitamin D levels in children with febrile seizures compared to febrile children without seizures.

Methods: A hospital-based case-control study was conducted at SMGS Hospital, Jammu, India, from November 2020 to October 2021. The study enrolled 100 children aged 6–60 months with febrile seizures (cases) and 100 age-matched febrile children without seizures (controls). Serum levels of calcium, magnesium, phosphorus, and vitamin D were measured using standardized laboratory methods. Data on age, sex, and nutritional status were collected. Statistical analysis used t-tests for continuous variables and chi-square tests for categorical variables (p<0.05 significant).

Results: Mean age was 24.82 months in cases and 22.83 months in controls (p=0.33). Males comprised 62% of cases (p=0.556). Hypocalcaemia was significantly more prevalent in cases (72%) than controls (42%, p<0.05). Mean serum magnesium was higher in cases (2.54 mg/dL) than controls (2.27 mg/dL, p<0.05), but hypomagnesemia was rare (p=0.47). Phosphorus levels showed no significant difference (3.87 mg/dL vs. 3.77 mg/dL, p=0.347). Vitamin D deficiency/insufficiency was more common in cases (47%) than controls (25%, p=0.001). No significant differences were found in sodium, potassium, or nutritional status. Upper respiratory tract infection was the primary fever trigger (47% cases).

Conclusion: Hypocalcaemia and vitamin D deficiency/insufficiency are significantly associated with febrile seizures, while magnesium and phosphorus levels show no consistent correlation. These findings suggest a role for calcium and vitamin D in febrile seizure pathogenesis.