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Severe hypomagnesaemia causing reversible cerebellopathy.

M G E Te Riele¹, A Verrips

¹Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands, Margot.teRiele@radboudumc.nl.

Cerebellum (London, England)

|May 20, 2014

Summary

Severe hypomagnesaemia, often linked to alcohol abuse, can cause cerebellar syndrome and hypertension. Prompt magnesium supplementation rapidly reversed these symptoms and MRI abnormalities.

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Area of Science:

Neurology
Clinical Medicine

Background:

Hypomagnesaemia is prevalent in hospitalized patients and frequently overlooked.
Chronic alcohol abuse and withdrawal are significant contributors to severe hypomagnesaemia.
Hypomagnesaemia can manifest with neurological symptoms, including ataxia, seizures, and cardiac arrhythmias.

Observation:

A 57-year-old male with chronic alcohol abuse presented with subacute cerebellar syndrome and hypertension post-alcohol withdrawal.
Laboratory tests revealed severe hypomagnesaemia (0.19 mmol/L).
Cerebellar MRI demonstrated diffuse T2 hyperintense lesions and swelling.

Findings:

Intravenous magnesium supplementation led to rapid improvement in neurological symptoms, hypertension, and MRI abnormalities.
The observed MRI findings resemble those in posterior reversible encephalopathy syndrome (PRES).
This case supports magnesium's role in the pathophysiology of PRES.

Implications:

Hypomagnesaemia should be considered in patients presenting with subacute cerebellar syndromes and hypertension.
Rapid magnesium repletion is crucial for reversing these neurological and hypertensive complications.
The findings suggest a potential link between magnesium deficiency and PRES-like conditions.