Status of Serum Calcium and Magnesium Levels among Children with Febrile Seizures.

Abstract

Febrile seizures are the most common seizure disorder in early childhood and are a frequent cause of pediatric hospital admission. Alterations in electrolyte balance, particularly ionized calcium and serum magnesium, may influence neuronal excitability and seizure threshold, but data remain inconsistent, especially in the Bangladeshi context. This study aims to evaluate the status of ionized calcium and serum magnesium levels in children with febrile seizures and to assess their association and diagnostic accuracy compared to febrile children without seizures. This hospital-based analytical case-control study was conducted in the Department of Paediatrics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from September 2021 to February 2022. Eighty children aged 6-60 months were enrolled, including 40 cases with febrile seizures and 40 age- and sex-matched febrile controls without seizures. Serum ionized calcium and serum magnesium levels were measured in both groups. Children with febrile seizures had significantly lower mean ionized calcium (4.48±0.31 g/dL vs. 4.67±0.20 mg/dL; p=0.002) and serum magnesium levels (1.66±0.34 mg/dL vs. 1.99±0.29 mg/dL; p<0.001) compared to controls. Hypocalcemia (45.0% vs. 15.0%; OR=4.5, p=0.005) and hypomagnesemia (40.0% vs. 12.5%; OR=4.6, p=0.008) were significantly more frequent among cases. A progressive decline in mean ionized calcium and serum magnesium levels were observed from simple febrile seizures to complex seizures and febrile status epilepticus. ROC analysis demonstrated moderate diagnostic accuracy for ionized calcium (AUC=0.68) and serum magnesium (AUC=0.78). Both ionized calcium and serum magnesium levels were significantly lower in children with febrile seizures, these biomarkers demonstrated moderate predictive value and may serve as supportive indicators in the evaluation of children with febrile seizures.