SHM Converge Scientific Abstract ePoster Gallery-Magnesium Matters: A Case of Hypomagnesemia Induced Cerebellar Syndrome

Pdf Summary

This case describes a 59-year-old man who developed confusion, dysarthria, weakness, diarrhea, ataxia, nystagmus, and dysmetria after a recent colchicine use for gout. He had a history of partial small bowel resection, gout, and prior lymphoma. Labs showed severe hypomagnesemia (0.3 mg/dL) along with hypokalemia and hypocalcemia. Brain CT and CSF studies were negative, but MRI showed cerebellar hyperintensity, supporting the diagnosis of hypomagnesemia-induced cerebellar syndrome, a rare and reversible condition that can mimic stroke or Wernicke’s encephalopathy.<br /><br />He was treated with intravenous magnesium and calcium replacement. Because diarrhea persisted and magnesium levels improved slowly, peripheral parenteral nutrition (PPN) was started, leading to faster correction of electrolytes and clinical improvement. His gait, weakness, and speech gradually improved, and he was discharged on oral magnesium. Three weeks later, he remained better.<br /><br />The report emphasizes that hypomagnesemia should be considered in patients with cerebellar symptoms, especially when accompanied by low potassium or calcium. MRI findings can help distinguish this syndrome from Wernicke’s encephalopathy, which typically affects the mammillary bodies or temporal lobes rather than the cerebellum. The authors note that this was the 25th reported case in the literature. Many cases have associated electrolyte abnormalities, and some patients experience lasting neurologic deficits or relapse.<br /><br />Key teaching points are that severe hypomagnesemia can cause neurologic symptoms and dangerous arrhythmias, seizures, and other complications, so patients should initially be managed in an intensive care setting. Early recognition and magnesium replacement are essential to prevent recurrence and permanent cerebellar injury.

Asset Subtitle

Aized Imtiaz

Meta Tag

Author List Aized Imtiaz, Shoshana Terebelo

Category Clinical Vignettes

Concept Hypomagnesemia-Induced Cerebellar Syndrome

Concept Severe Hypomagnesemia

Concept Magnesium Repletion

Concept Ataxia

Concept Hypocalcemia

Distinguished Non-Finalist

Presenter Organization Medicine

Presenting Author Aized Imtiaz

Track Adult

Keywords

hypomagnesemia

cerebellar syndrome

colchicine toxicity

gout

ataxia

nystagmus

dysarthria

magnesium replacement

MRI cerebellar hyperintensity

electrolyte imbalance

Hypomagnesemia-Induced Cerebellar Syndrome

Severe Hypomagnesemia

Magnesium Repletion

Ataxia

Hypocalcemia