Hypocalcaemic Tetany and Seizures Secondary to Vitamin D Deficiency.

Abstract

Presentation: A female adolescent presented with a generalised tonic-clonic seizure preceded by hands stiffness. She presented with a sudden history of being unresponsive with head deviation to right side, followed by up-rolling of eyes, and whole body shaking which self-terminated after five minutes. On examination, she was in postictal state, with inward clenching of both hands and fingers. The rest of her systemic examination was normal.

Diagnosis: Laboratory results showed severe hypocalcaemia, hypomagnesaemia, hyperphosphatemia, elevated parathyroid hormone (PTH), and critically low vitamin D. ECG showed a prolonged QTc interval. Biochemical profile was consistent with secondary hyperparathyroidism. Severe vitamin D deficiency was the cause of her hypocalcaemia.

Treatment: The patient was managed acutely with intravenous calcium gluconate and magnesium, followed by oral calcium and vitamin D supplementation.

Discussion: This case highlights hypocalcaemia-induced seizures due to vitamin D deficiency in an adolescent, emphasising the importance of early recognition, biochemical assessment, and supplementation in at-risk populations.