Neurologic Manifestations of Magnesium Depletion States

Abstract

Mg depletion in animals produces general irritability, muscular tremor, vasodilatation, dermatitis, decreased growth and convulsions. The manifestations of Mg depletion in man as reflected by low serum Mg levels include tremor, muscular twitching, delirium, hallucinosis, apprehensive behavior, and convulsions. Twelve cases occurring in patients with chronic alcoholism are reported. In addition, a case associated with severe burns, parenteral fluid administration, osteoporosis, and renal disease, and one associated with pregnancy, renal disease, and pseudohypoparathyroidism are described. Serum Mg levels below 1.5 meq/l were found in most cases with severe symptoms. Treatment with Mg sulfate given intravenously or intramuscularly is safe and appears to produce clinical improvement. A review of possible mechanisms by which Mg depletion produces symptoms suggests that a marked change in ratio between intracellular and extracellular Mg levels may be at fault. It appears that in Mg depletion states intracellular Mg is normal or possibly increased though serum Mg is decreased, and this, rather than depletion of intracellular Mg, is the basic defect.