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Serum calcium and magnesium abnormalities in patients with status epilepticus: a single centre tertiary care experience

Abstract

Electrolyte imbalances frequently cause seizures, and these seizures may be the sole presenting symptom. Seizures are especially common in patients with sodium disorders, hypocalcemia, and hypomagnesemia. Successful management of patient seizures begins with the establishment of an accurate diagnosis of the underlying electrolyte disturbance, because rapid identification and correction of the disturbance is necessary to control seizures and prevent permanent brain damage. Objectives: To delineate the percentage of people with status epilepticus having calcium and magnesium deficiencies at admission. Methods: The study was carried out from April 2013 to October 2013 at Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. Seventy patients diagnosed with status epilepticus were enrolled in the study and frequencies of serum calcium & magnesium abnormalities were measured and compared. Results: Calcium level was low in 29 (41.4%) patients. Magnesium level was low only in 7 (10%) patients. Both calcium & magnesium levels were low in 7 (10%) patients. Among the known epileptics, 16 (76.1%) were on regular antiepileptic treatment. Among those on antiepileptic drugs, 8 (50%) had low calcium levels while 6 (37.5%) had low magnesium levels. Conclusion: Serum calcium level was lower in nearly half while magnesium in nearly 2/5th of the previously diagnosed epileptics who presented in status. Among those on antiepileptic drugs, 50% had low calcium levels while 37.5% had low magnesium levels. It is suggested that all epileptic patients, especially those on long term AEDs, should at least be worked up once in detail for electrolyte abnormalities as timely identification and correction can help reduce the morbidity and mortality associated with future status epilepticus

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