Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
BMJ Case Rep. 2021 Apr 13;14(4):e239777. doi: 10.1136/bcr-2020-239777.
This case report describes a patient who presented with acute left facial numbness and eyelid weakness prompting work-up, which demonstrated low suspicion for new stroke but revealed hypomagnesaemia as a potential differential diagnosis. Patient initially presented to the emergency department with left upper extremity weakness and was diagnosed with right basal ganglia infarction. Two weeks after transfer to the acute rehabilitation unit, patient suddenly complained of left facial numbness and eyelid weakness. However, brain imaging did not show any new acute infarct. Instead, laboratory results showed hypomagnesaemia at 1.50 mg/dL. Patient was therefore treated with intravenous magnesium leading to resolution of his symptoms. Up to 30% of acute stroke presentations are stroke mimics. Although hypomagnesaemia is less frequently seen as a mimic, its neuromuscular manifestations may present with similar symptoms. Patients will always benefit from a comprehensive evaluation for stroke symptoms, but it is important to consider the mimics as well.
本病例报告描述了一位出现急性左侧面部麻木和眼睑无力的患者，促使进行了相关检查，结果提示新发卒中的可能性较低，但发现低镁血症可能是潜在的鉴别诊断。患者最初因左侧上肢无力就诊于急诊，并被诊断为右侧基底节梗死。在转入急性康复病房两周后，患者突然抱怨左侧面部麻木和眼睑无力。然而，脑部影像学检查未显示任何新的急性梗死。相反，实验室结果显示镁 1.50mg/dL。因此，患者接受了静脉镁治疗，症状得到缓解。高达 30%的急性卒中表现为卒中样发作。尽管低镁血症作为一种类似物不太常见，但它的神经肌肉表现可能出现类似的症状。对卒中症状进行全面评估始终对患者有益，但也必须考虑到类似物。
