title: Hypocalcemic seizures and secondary bilateral femoral fractures in an adolescent with primary vitamin D deficiency.
abstract: Nutritional rickets and osteomalacia are reemerging in Western societies, particularly in young children and in adolescents of African or Asian descent. Hypocalcemic seizures resulting from vitamin D deficiency are rare in adolescents, whereas fractures caused by seizures without evidence of direct trauma have not yet been reported in this population. We present an unusual case of secondary bilateral femoral fractures caused by hypocalcemic seizures in a 17-year-old boy with primary vitamin D deficiency. We examine the epidemiology and the clinical presentation of rickets and osteomalacia in the adolescent population, the risk of secondary injuries in patients with seizures, and the evaluation and management of hypocalcemic seizures and primary vitamin D deficiency.
authors.affiliation: Division of Pediatric Emergency Medicine, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center, New York, NY 10032, USA. ds2194@columbia.edu
authors.forename: David
authors.initials: D
authors.lastname: Schnadower
authors.forename: Chhavi
authors.initials: C
authors.lastname: Agarwal
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Oberfield
authors.forename: Ilene
authors.initials: I
authors.lastname: Fennoy
authors.forename: Martin
authors.initials: M
authors.lastname: Pusic
mesh_terms: D000293:Adolescent; D005264:Femoral Fractures / Q000209:etiology*; D006801:Humans; D006996:Hypocalcemia / Q000150:complications*; D008297:Male; D012640:Seizures / Q000209:etiology*; D014808:Vitamin D Deficiency / Q000150:complications*