Voci P, Bilotta F, Sandoz W, De Vito A, Caprettini S, Wagner S L, Viola R
II Cattedra di Malattie dell'Apparato Cardiovascolare, Università degli Studi La Sapienza, Roma.
Cardiologia. 1990 Jan;35(1):79-81.
The case of a patient developing hypomagnesemic encephalopathy and coma secondary to intensive treatment for severe cardiac failure, is reported. Following an early improvement of symptoms and signs of cardiac failure, a rapidly developing neurologic disorder appeared. This was characterized by insomnia, agitation, mental derangement and, finally, sopor and I-II degree coma. Serum magnesium concentration was 1.0 mEq/l. Magnesium sulfate iv infusion was followed by a immediate and complete recovery from the neurological disorder. Patients with cardiac failure undergoing prolonged intensive therapy are prone to develop hypomagnesemia. This electrolyte alteration may be responsible for symptoms and signs of central nervous system involvement (metabolic encephalopathy) that need to be differentiated from those of organic origin.
报告了一例因严重心力衰竭强化治疗继发低镁血症性脑病和昏迷的患者病例。在心力衰竭的症状和体征早期改善后,出现了迅速发展的神经功能障碍。其特征为失眠、躁动、精神错乱,最终出现嗜睡和Ⅰ - Ⅱ度昏迷。血清镁浓度为1.0 mEq/l。静脉输注硫酸镁后,神经功能障碍立即完全恢复。接受长期强化治疗的心力衰竭患者容易发生低镁血症。这种电解质改变可能是中枢神经系统受累症状和体征(代谢性脑病)的原因,需要与器质性病变相鉴别。