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Efficacy of Oral vs. Intravenous Calcium Supplementation for Continuation Therapy in Hypocalcemic Seizures: A Randomized, Controlled Trial

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Abstract

Objective

To evaluate efficacy of oral vs. intravenous calcium supplementation for continuation therapy in hypocalcemic seizures.

Methods

Sixty children between 1 mo and 5 y presenting with hypocalcemic seizures without any other underlying febrile, chronic systemic disease, or acute neurological illness were included. Participants were randomized to receive either intravenous (IV) 10% calcium gluconate (n = 30) or oral elemental calcium (n = 30) for 48 h following initial seizure control with intravenous calcium.

Results

Seizures recurred in 3 (10%) children in IV group as compared to 4 (13.3%) in oral calcium group (p = 0.278) within 48 h. Serum calcium levels achieved in the two treatment groups at 24 h [7.96 (1.32) vs. 8.23 (1.58) mg/dL; p = 0.476] and 48 h [8.5 (1.01) vs. 8.63 (1.39) mg/dL; p = 0.681] were comparable.

Conclusion

Oral calcium may be as efficacious as intravenous calcium during continuation phase of treating hypocalcemic seizures; however, further studies are needed for definite recommendations.

Trial Registration

Trial Registration number: CTRI/2017/12/011042.

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Authors and Affiliations

  1. Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095, India

    Himanshu Dhir, Deepak Kumar, Dheeraj Shah, Prerna Batra & Piyush Gupta

  2. Department of Biochemistry, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India

    Rafat S. Ahmed

Authors
  1. Himanshu Dhir
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  2. Deepak Kumar
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  3. Dheeraj Shah
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  4. Prerna Batra
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  5. Rafat S. Ahmed
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  6. Piyush Gupta
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Contributions

HD, DK: Collected the data, wrote the first draft of manuscript; DS, PG: Conceptualized the study, devised its design, and provided critical inputs into manuscript revision; PB and RSA: Supervised data collection and conduct of study, and provided critical inputs into manuscript revision. All authors approved the final version of the study as submitted, and are willing to be accountable for all aspects of the study. PG will act as the guarantor for this paper.

Corresponding author

Correspondence to Piyush Gupta.

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Dhir, H., Kumar, D., Shah, D. et al. Efficacy of Oral vs. Intravenous Calcium Supplementation for Continuation Therapy in Hypocalcemic Seizures: A Randomized, Controlled Trial. Indian J Pediatr 90, 433–437 (2023). https://doi.org/10.1007/s12098-022-04178-0

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  • DOI: https://doi.org/10.1007/s12098-022-04178-0

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