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Reversible cerebellar oedema secondary to profound hypomagnesaemia
  1. Amy Louise Ross Russell1,
  2. Martin Prevett1,
  3. Paul Cook2,
  4. Charles Simon Barker3,
  5. Ashwin Arnold Pinto1
  1. 1Neurology department, Wessex Neurosciences Centre, Southampton General Hospital, Southampton, UK
  2. 2Clinical biochemistry, Southampton General Hospital, Southampton, UK
  3. 3Neuroradiology department, Wessex Neurosciences Centre, Southampton General Hospital, Southampton, UK
  1. Correspondence to Dr Amy Louise Ross Russell, Wessex Neurological Centre, Southampton General Hospital, Southampton SO16 6YD, UK; amy.rossrussell{at}uhs.nhs.uk

Abstract

Magnesium is the second most abundant intracellular cation. Deficiency can cause several neurological complications, including cerebellar syndromes, with various MRI findings. These include cerebellar oedema, presumably through a similar mechanism to that in posterior reversible encephalopathy syndrome (PRES). People particularly vulnerable to deficiency include those with high alcohol consumption, excessive loss due to gastrointestinal pathology and those taking certain medications, including proton pump inhibitors. We report three patients with cerebellar syndromes associated with hypomagnesaemia. These cases support the previously reported association between hypomagnesaemia and reversible cerebellar dysfunction and illustrate the range of potential presentations. They highlight an uncommon but treatable cause of cerebellar ataxia that may present to acute neurological liaison services.

  • cerebellar oedema
  • hypomagnesaemia
  • proton pump inhibitors
  • alcohol-related problems

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Footnotes

  • Contributors ALRR: prepared the manuscript with review from all authors. AAP: was the responsible consultant for the second patient and advised on all revisions of the manuscript. PC: offered clinical advice on biochemical interpretation of patients results and advised on all revisions of the manuscript. CSB: reviewed the imaging for all cases and compared this with previous reported cases; also reviewed all revisions of the manuscript. AAP: was the responsible consultant for the first and third case, suggested the case report and reviewed all revisions of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Maxwell Damian, Cambridge, UK.

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