Four weeks after elective embolisation of a symptomatic benign uterine fibroid, a lady presented to her general practitioner with facial twitching and severe lassitude. Acute hypocalcaemia was diagnosed. Further investigations demonstrated hypomagnesaemia. Parathyroid hormone (PTH) was within normal limits. Symptoms and the acute metabolic disturbance resolved with treatment by oral magnesium and calcium supplementation. While lassitude is a common symptom of postfibroid embolisation and may last for up to 6 weeks, the presentation with facial twitching alerted the clinician to a potential electrolyte or metabolic imbalance. This is a first reported case of hypomagnesaemia associated with PTH resistance leading to hypocalcaemia precipitated by alcohol particle embolisation for benign fibroid disease.

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