Double-blind controlled study of primidone in essential tremor.

The main interest in this case is that the patient's fits started only towards the end of a prolonged period of lactation, during which calcium losses would be expected to increase.3 We speculate that lactation was a major factor in inducing the convulsions since it may have reduced an already low plasma calcium concentration to epileptogenic levels. A further possibility is that she had a familial tendency to epilepsy that became manifest only in the hypocalcaemic state. Many neurologists do not perform routine biochemical screening in patients presenting with epilepsy: although it may not be justifiable economically to measure plasma calcium concentrations in every patient with epilepsy, we suggest that it is wise to exclude hypocalcaemia in any patient who presents with convulsions during lactation, even if there is a family history of epilepsy.