Posterior Reversible Encephalopathy Syndrome due to Hypomagnesemia: A Case Report and Literature Review

Table 1

Cerebellar syndrome due to hypomagnesemia in the literature.

Publication	Age (years)	Sex	Neurological symptoms on admission	Imaging	Mg	Na	Ca	K	PTH	Etiology	Follow-up
[4]	78	M	PDBN	CCT: n; MRI: cerebrovascular chronic ischemia and slight cerebral and cerebellar atrophy	Not detectable	n	↓	n	N/A	Probably attacks of diarrhea caused by diverticulitis	PDBN disappeared after two weeks.; A temporary reoccurrence was observed on day 17
[12]	61	F	Ataxia, paresthesia, cognitive impairment	Brain and cord MRI: n	1.5 mEq/l	N/A	N/A	N/A	N/A	TRPM6 mutation	Reoccurrence after 2 months
[8]	72	M	Severe dysarthria, ataxia, dysphagia, nystagmus	MRI: hyperintensities within both cerebellar hemispheres similar to PRES	0.15 mmol/l	N/A	↓	N/A	↑	Short bowel syndrome after surgical treatment of adenocarcinoma and diarrhea	MRI and clinic were unremarkable after 2 months
[11]	68	F	Seizure, PDBN	MRI: a lesion within the cerebellar nodulus	7 mg/l (range: 18–24 mg/l)	n	↓	↓	↑	Undetermined	Reoccurrence after 2 months
[7]	59	M	Ataxia, vertical nystagmus, seizures, PDBN	MRI: hyperintensity and swelling of the cerebellar nodulus	<0.08 mmol/l (normal range: 0.75–1.0 mmol/l)	↓	↓	↓	N/A	Short bowel syndrome after ileostomy due to ulcerative colitis	N/A
[16]	66	F	Dysphagia, diplopia, vertical nystagmus, weakness, cognitive impairment	N/A	0.21 mEq/l (range: 1.4–2.0 mEq/l)	n	n	n	N/A	Short bowel syndrome after colectomy due to metastases of cervix carcinoma	Symptoms improved, dysphagia resolved after 2 months
[17]	67	F	PDBN, ataxia	N/A	1.1–1.4 mmol/l (range: 1.5–2.5 mmol/l)	N/A	↓	N/A	N/A	Side effect of lithium carbonate	Symptoms resolved in 4 months
[5]	21	M	PDBN, ataxia, dysphagia, tachycardia, seizures	CCT: n	<1 mg/dl	N/A	N/A	↓	N/A	Parenteral nutrition, short bowel syndrome after ileocolectomy for Crohn’s disease	Complete recovery after 6 weeks
[5]	44	F	Seizures, PDBS	CCT: n	0.9 mg/ml (range: 1.5–3.5 mg/dl)	N/A	↓	↓	N/A	Parenteral nutrition, resection of terminal ileum and cecum because of metastatic fallopian adenocarcinoma	Persistence of downbeat nystagmus; death because of cancer complications after 3 months
[9]	57	M	Seizure, dysarthria, ataxia	MRI: hyperintense lesions in both cerebellar hemispheres and the vermis resembling PRES	0.19 mmol/l	N/A	N	↓	N/A	Alcohol abuse	Significant improvement after 6 months
[18]	65	M	Ataxia, cognitive impairment, seizure	MRI: hyperintensities within the cerebellar vermis	0.08 mmol/l (range: 0.7–0.9 mmol/l)	N/A	↓	↓	↓↓↓	Pantoprazole	Mild memory deficit is still observed after 6 months

M: male; F: female; PDBN: paroxysmal downbeat nystagmus; n: normal; N/A: not available; Mg: magnesium; Ca: calcium; K: potassium; PTH: parathormone hormone; MRI: magnetic resonance imaging; CCT: cranial computed tomography. mEq/l: milliequivalents per liter; mmol/l: millimoles per liter; mg/dl: milligrams per deciliter; mg/ml: milligrams per milliliter. ↓: low; ↓↓↓: very low; ↑: high.