Ray Somdattaa, Park Kye Won
Division of Neurology, University of British Columbia.
Neurol Clin Pract. 2023 Dec;13(6):e200202. doi: 10.1212/CPJ.0000000000200202. Epub 2023 Oct 2.
The objective of this study was to explore the clinical spectrum of movement disorders and associated neurologic findings in hypomagnesemia and challenges in diagnosis and treatment.
Sixty patients were identified in the literature for analysis. Movement disorders observed were postural tremor (23.3%, n = 14), resting tremor (8.3%, n = 5), intention tremor (10%, n = 6), ataxia involving the trunk (48.3%, n = 29) or limbs (25%, n = 15) and dysarthria (21.7%, n = 13), athetosis (8.3%, n = 5), myoclonus (6.7%, n = 4), and chorea (1.8%, n = 1). Symptoms may be accompanied by downbeat nystagmus, tetany, drowsiness, vertigo, and proximal muscle weakness. Residual deficits were noted in 16 (26.67%) patients. Serum magnesium was 1.3 mg/dL or lower in 53 patients (88.3%). Imaging findings include bilateral cerebellar (20%, n = 11) and vermis hyperintensities (9.09%, n = 5) and normal imaging. Proton pump inhibitors are the commonest etiology.
The movement disorders linked with hypomagnesemia can be associated with varied neurologic symptoms. A high degree of suspicion will enable early diagnosis to prevent residual deficits.
本研究旨在探讨低镁血症中运动障碍的临床谱、相关神经系统表现以及诊断和治疗方面的挑战。
在文献中确定了60例患者进行分析。观察到的运动障碍包括姿势性震颤（23.3%，n = 14）、静止性震颤（8.3%，n = 5）、意向性震颤（10%，n = 6）、涉及躯干（48.3%，n = 29）或四肢（25%，n = 15）的共济失调以及构音障碍（21.7%，n = 13）、手足徐动症（8.3%，n = 5）、肌阵挛（6.7%，n = 4）和舞蹈症（1.8%，n = 1）。症状可能伴有下跳性眼球震颤、手足搐搦、嗜睡、眩晕和近端肌无力。16例（26.67%）患者有残留缺陷。53例患者（88.3%）血清镁低于1.3mg/dL。影像学表现包括双侧小脑高信号（20%，n = 11）和蚓部高信号（9.09%，n = 5）以及正常影像学表现。质子泵抑制剂是最常见的病因。
与低镁血症相关的运动障碍可能伴有多种神经系统症状。高度怀疑有助于早期诊断以预防残留缺陷。
