Hypomagnesemia-induced cerebellar syndrome: a case report

Abstract

Magnesium is the second most abundant intracellular cation after potassium and is involved in over 600 enzymatic reactions that are essential for life. Hypomagnesemia (serum magnesium concentration <1.8 mg/dL (< 0.70 mmol/L)), is longstanding known to cause many clinical disorders: other electrolyte abnormalities, life-threatening arrhythmias and various neurological manifestations, from muscle cramps and myopathy, to vertigo, nystagmus, depression, acute confusional state and seizures. In the last few years some case reports have highlighted the possible existence of a peculiar hypomagnesemia induced cerebellar syndrome (HiCS). Here we present a clinical case of a 74-years-old man with severe hypomagnesemia presenting with vomiting, gait instability, diffuse tremor, associated with neuro-otological signs of cerebellar dysfunction and a MRI hyperintense lesion at cerebellar nodulus with clinico-radiological resolution after magnesium repletion.