Hypomagnesemia-Induced Cerebellar Syndrome—A Distinct Disease Entity? Case Report and Literature Review

Abstract

Clinical consequences of hypomagnesemia are manifold and include various neurological syndromes up to life-threatening conditions. Despite its importance, magnesium is generally not routinely determined leading to an under-recognition of hypomagnesemia-related disorders. In the past years, there are growing numbers of reports of hypomagnesemia-induced cerebellar syndromes (HiCS) with corresponding cerebellar edema, which might be a distinct disease entity. To provide further insights into HiCS, we describe a patient with HiCS and performed a literature review on cerebellar syndromes due to severe hypomagnesemia with regard to the clinical, MRI, and laboratory findings. We identified 17 cases, so including our case, 18 cases contribute to this review. Summarized, HiCS seems to be a distinct disease entity because of the remarkable similarities of clinical, MRI, and laboratory features. It should be diagnosed and treated early to avoid recurrent disease courses, residual symptoms, and potentially life-threatening conditions such as seizures. Physicians must be alert to HiCS as magnesium is usually not part of the routine electrolyte panel.

Ataxien – Eine aktuelle Übersicht über die weiter wachsende Anzahl möglicher Diagnosen

“…Ursache der Duralecks können Bandscheibenvorfälle, spinale Traumata oder Operationen und selten Erkrankun-▶ Tab. 1 Laborparameter zur Abklärung erworbener Ataxien [3,7,9,10].…”

Hypomagnesaemia Induced Reversible Cerebellar Syndrome

“…1 Its reputation as a 'membrane stabiliser' leads to its therapeutic ubiquity; finding use in the treatment of severe asthma 2 pre-eclampsia 3 and cardiac arrhythmias, 4 as well as the prevention of cerebral palsy in preterm delivery. 5 Hypomagnesaemia most commonly results from gastrointestinal loss secondary to diarrhoea, 1 as well as through dietary deficiency, 6 hyperparathyroidism, renal loss 1 and some drugs such as diuretics 1 and proton-pump inhibitors (PPIs). [6][7] Magnesium deficiency may cause cardiac dysrhythmias, 1 in addition to a variety of neurological signs such as muscle weakness, 8 muscle cramps, spasm, tremor, seizures and athetosis.…”

“…5 Hypomagnesaemia most commonly results from gastrointestinal loss secondary to diarrhoea, 1 as well as through dietary deficiency, 6 hyperparathyroidism, renal loss 1 and some drugs such as diuretics 1 and proton-pump inhibitors (PPIs). [6][7] Magnesium deficiency may cause cardiac dysrhythmias, 1 in addition to a variety of neurological signs such as muscle weakness, 8 muscle cramps, spasm, tremor, seizures and athetosis. 1,6,[9][10] Low magnesium may also produce secondary pathologies relating to other electrolyte imbalances due to its role in enzyme ligand formation in cation transport across the cellular membrane.…”

“…[6][7] Magnesium deficiency may cause cardiac dysrhythmias, 1 in addition to a variety of neurological signs such as muscle weakness, 8 muscle cramps, spasm, tremor, seizures and athetosis. 1,6,[9][10] Low magnesium may also produce secondary pathologies relating to other electrolyte imbalances due to its role in enzyme ligand formation in cation transport across the cellular membrane. 1 Hypokalemia and intracellular accumulation of sodium and calcium may result as these ions decrease down their concentration gradients when active transport systems such as Na-K-ATPase are impaired.…”

Ataxien – Eine aktuelle Übersicht über die weiter wachsende Anzahl möglicher Diagnosen

“…Laborparameter zur Abklärung erworbener Ataxien[3,7,9,10]. Humangenetische Stufendiagnostik zur Abklärung von Ataxien.…”