Hypocalcemia-induced seizure: demystifying the calcium paradox

ASN Neuro. 2015 Mar 24;7(2):1759091415578050. doi: 10.1177/1759091415578050. Print 2015 Mar-Apr.


Calcium is essential for both neurotransmitter release and muscle contraction. Given these important physiological processes, it seems reasonable to assume that hypocalcemia may lead to reduced neuromuscular excitability. Counterintuitively, however, clinical observation has frequently documented hypocalcemia's role in induction of seizures and general excitability processes such as tetany, Chvostek's sign, and bronchospasm. The mechanism of this calcium paradox remains elusive, and very few pathophysiological studies have addressed this conundrum. Nevertheless, several studies primarily addressing other biophysical issues have provided some clues. In this review, we analyze the data of these studies and propose an integrative model to explain this hypocalcemic paradox.

Keywords: action potential; hypocalcemia; ion channel; neurophysiology; seizure; synaptic transmission.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Calcium / metabolism
  • Humans
  • Hypocalcemia / complications*
  • Hypocalcemia / physiopathology*
  • Membrane Potentials / physiology
  • Neurons / physiology
  • Seizures / etiology*
  • Seizures / physiopathology*


  • Calcium