Reversible cerebellar syndrome induced by hypomagnesemia

Santos, Ana Filipa; Sousa, Filipa; Rodrigues, Margarida; Ferreira, Carla; Soares-Fernandes, João; Maré, Ricardo

doi:10.1111/ncn3.183

Cited by 16 publications

(16 citation statements)

References 6 publications

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“…The neurological examination on admission predominately yielded cerebellar symptoms including severe dysarthria, cerebellar ataxia, and nystagmus. Different forms of nystagmus were described; however, downbeat nystagmus as reported in 6/18 patients seems to be quite typical and a result of the frequent affection of the vermis and cerebellar nodulus as seen on MRI ( Table 2 ) ( 4 – 7 , 11 ). In addition, periodic/intermittent nystagmus might hint to HiCS as well being an overall rare neurological presentation ( 4 , 7 ).…”

Section: Discussionmentioning

confidence: 96%

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

et al. 2020

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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.

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Section: Discussionmentioning

confidence: 96%

“…In recent years, there is a growing number of reports of hypomagnesemia-induced cerebellar syndromes with corresponding cerebellar edema seen on MRI which might be a distinct disease entity (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…8 However, hypomagnesemia has been associated with a variety of neurological symptoms, including reversible mental status changes, seizures, and movement disorders. 9 Among the focal manifestations, the most reported are cerebellar symptoms due to endothelial malfunction, presenting with reversible abnormalities on neuroimaging similar to those of posterior reversible encephalopathy syndrome. 9 – 11 There is, however, a case of a 3-year-old boy who presented with aphasia in the context of severely low levels of serum magnesium.…”

Section: Discussionmentioning

confidence: 99%

“… 9 Among the focal manifestations, the most reported are cerebellar symptoms due to endothelial malfunction, presenting with reversible abnormalities on neuroimaging similar to those of posterior reversible encephalopathy syndrome. 9 – 11 There is, however, a case of a 3-year-old boy who presented with aphasia in the context of severely low levels of serum magnesium. 12 The history of proton pump inhibitors usage, prodromal symptoms of anorexia and nausea, low blood potassium levels, and normalcy of the perfusion imaging should have made us suspect that an SM was present in this case.…”

Section: Discussionmentioning

confidence: 99%

Dilemma in the emergency setting: hypomagnesemia mimicking acute stroke

Rico¹,

Martínez-Rodríguez²,

Larrosa-Campo³

et al. 2016

IMCRJ

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BackgroundStroke mimics may account for up to 30% of all acute stroke consultations. However, in the emergency setting, accurate diagnosis is not always possible.MethodsCase report and review of the literature.ResultsA 73-year-old woman was admitted to the emergency department with acute aphasia and right hemiparesis. The National Institute of Health Stroke Score was 21, compatible with severe stroke, so she received thrombolysis. Laboratory testing demonstrated severe hypomagnesemia. She had been taking proton pump inhibitors for years and neuroimaging did not demonstrate signs of acute ischemic disease. After correcting the metabolic alterations with intravenous and oral supplemental magnesium, the patient was discharged asymptomatic. No further episodes have been registered to date.ConclusionHypomagnesemia might cause acute neurological symptoms that could be confused with stroke. A careful history is essential for diagnosis but suspicion of stroke mimic should not prevent tPA administration.

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“…It is important in stabilising vascular endothelium and regulating neurotransmitter function 1. Up to 12% of hospitalised patients have hypomagnesaemia, and its incidence may be as high as 60% in intensive care units 2.…”

Section: Introductionmentioning

confidence: 99%

Reversible cerebellar oedema secondary to profound hypomagnesaemia

et al. 2018

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Magnesium is the second most abundant intracellular cation. Deficiency can cause several neurological complications, including cerebellar syndromes, with various MRI findings. These include cerebellar oedema, presumably through a similar mechanism to that in posterior reversible encephalopathy syndrome (PRES). People particularly vulnerable to deficiency include those with high alcohol consumption, excessive loss due to gastrointestinal pathology and those taking certain medications, including proton pump inhibitors. We report three patients with cerebellar syndromes associated with hypomagnesaemia. These cases support the previously reported association between hypomagnesaemia and reversible cerebellar dysfunction and illustrate the range of potential presentations. They highlight an uncommon but treatable cause of cerebellar ataxia that may present to acute neurological liaison services.

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Reversible cerebellar syndrome induced by hypomagnesemia

Cited by 16 publications

References 6 publications

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

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

Dilemma in the emergency setting: hypomagnesemia mimicking acute stroke

Reversible cerebellar oedema secondary to profound hypomagnesaemia

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