Hyponatremia-Induced Seizures Secondary to Magnesium Citrate Colon Cleansing Agent

Abstract

Mild and clinically insignificant electrolyte disturbances are a well-recognised complication of all bowel preparation. Seizure as a complication is very rare. Magnesium citrate, a hyperosmolar substance, is often used for bowel preparation before colonoscopy and colon surgery. We report a 74-years-old female, with no prior history of seizures, who had her first seizure associated with hyponatremia following ingestion of magnesium citrate for bowel preparation. A careful correction of serum sodium must be undertaken. The patient improved her mental status to baseline after intravenous infusion of hypertonic saline. The other causes of hyponatremia and seizure were ruled out. This case highlights the association between magnesium citrate bowel preparations with significant hyponatremia and seizure. The physicians in the ED and general practice need to be aware of this serious complication of magnesium citrate bowel preparation to diagnose them early and initiate timely management.