Unraveling the Puzzle: A Case of Intricate Neurological Presentation Attributable to Hypomagnesemia

Hypomagnesemia can occasionally present with severe neurological deficiencies, and it is usually attributed to an underlying renal and/or gastrointestinal pathology. Rarely, patients may present with neurological symptoms in the absence of an obvious cause. Our case highlights the importance of considering hypomagnesemia as a primary cause of those presenting with severe neurological deficits in an intensive care unit setting, as well as the significance of conducting a thorough social and medical history on these patients to elucidate their underlying causes. We discuss the case of a 48-year-old Caucasian male who acutely presented with seizures, tremors, visual hallucinations, diplopia, personality changes, and ataxia with recurring severely low magnesium (0.4 mg/dL) at times in the absence of renal, gastrointestinal, hormonal, infectious, or autoimmune pathology.