1
|
Pethő ÁG, Fülöp T, Orosz P, Tapolyai M. Magnesium Is a Vital Ion in the Body-It Is Time to Consider Its Supplementation on a Routine Basis. Clin Pract 2024; 14:521-535. [PMID: 38525719 PMCID: PMC10961779 DOI: 10.3390/clinpract14020040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 03/26/2024] Open
Abstract
The importance of maintaining proper magnesium intake and total body magnesium content in preserving human health remains underappreciated among medical professionals and laymen. This review aimed to show the importance of hypomagnesemia as a modifiable risk factor for developing disease processes. We searched the PubMed database and Google Scholar using the keywords 'magnesium', 'diabetes', 'cardiovascular disease', 'respiratory disease', 'immune system', 'inflammation', 'autoimmune disease', 'neurology', 'psychiatry', 'cognitive function', 'cancer', and 'vascular calcification'. In multiple contexts of the search terms, all reviews, animal experiments, and human observational data indicated that magnesium deficiency can lead to or contribute to developing many disease states. The conclusions of several in-depth reviews support our working hypothesis that magnesium and its supplementation are often undervalued and underutilized. Although much research has confirmed the importance of proper magnesium supply and tissue levels, simple and inexpensive magnesium supplementation has not yet been sufficiently recognized or promoted.
Collapse
Affiliation(s)
- Ákos Géza Pethő
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Tibor Fülöp
- Medicine Service, Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA; (T.F.); (M.T.)
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Petronella Orosz
- Bethesda Children’s Hospital, 1146 Budapest, Hungary;
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Mihály Tapolyai
- Medicine Service, Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA; (T.F.); (M.T.)
- Department of Nephrology, Szent Margit Kórhaz, 1032 Budapest, Hungary
| |
Collapse
|
2
|
Pandey AK, Nigwekar P. Familial Hypomagnesemia with Secondary Hypocalcemia Presenting as Refractory Seizures. Ann Indian Acad Neurol 2023; 26:599-601. [PMID: 37970287 PMCID: PMC10645241 DOI: 10.4103/aian.aian_38_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 01/26/2023] [Indexed: 11/17/2023] Open
Affiliation(s)
- Amit Kumar Pandey
- Department of Pediatrics, Rural Medical College and Pravara Rural Hospital, PIMS, Loni, Maharashtra, India
| | - Prashant Nigwekar
- Department of Pediatrics, Rural Medical College and Pravara Rural Hospital, PIMS, Loni, Maharashtra, India
| |
Collapse
|
3
|
Liu M, Liu H, Feng F, Krook-Magnuson E, Dudley SC. TRPM7 kinase mediates hypomagnesemia-induced seizure-related death. Sci Rep 2023; 13:7855. [PMID: 37188671 DOI: 10.1038/s41598-023-34789-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/08/2023] [Indexed: 05/17/2023] Open
Abstract
Hypomagnesemia (HypoMg) can cause seizures and death, but the mechanism is unknown. Transient receptor potential cation channel subfamily M 7 (TRPM7) is a Mg transporter with both channel and kinase function. In this study, we focused on the kinase role of TRPM7 in HypoMg-induced seizures and death. Wild type C57BL/6J mice and transgenic mice with a global homozygous mutation in the TRPM7 kinase domain (TRPM7K1646R, with no kinase function) were fed with control diet or a HypoMg diet. After 6 weeks of HypoMg diet, mice had significantly decreased serum Mg, elevated brain TRPM7, and a significant rate of death, with females being most susceptible. Deaths were immediately preceded by seizure events. TRPM7K1646R mice showed resistance to seizure-induced death. HypoMg-induced brain inflammation and oxidative stress were suppressed by TRPM7K1646R. Compared to their male counterparts, HypoMg female mice had higher levels of inflammation and oxidative stress in the hippocampus. We concluded that TRPM7 kinase function contributes seizure-induced deaths in HypoMg mice and that inhibiting the kinase reduced inflammation and oxidative stress.
Collapse
Affiliation(s)
- Man Liu
- Cardiovascular Division, Department of Medicine, The Lillehei Heart Institute, University of Minnesota at Twin Cities, 2231 6th Street SE, CCRB 4-141, Minneapolis, MN, 55455, USA
| | - Hong Liu
- Cardiovascular Division, Department of Medicine, The Lillehei Heart Institute, University of Minnesota at Twin Cities, 2231 6th Street SE, CCRB 4-141, Minneapolis, MN, 55455, USA
| | - Feng Feng
- Cardiovascular Division, Department of Medicine, The Lillehei Heart Institute, University of Minnesota at Twin Cities, 2231 6th Street SE, CCRB 4-141, Minneapolis, MN, 55455, USA
| | - Esther Krook-Magnuson
- Department of Neuroscience, University of Minnesota at Twin Cities, Minneapolis, MN, USA
| | - Samuel C Dudley
- Cardiovascular Division, Department of Medicine, The Lillehei Heart Institute, University of Minnesota at Twin Cities, 2231 6th Street SE, CCRB 4-141, Minneapolis, MN, 55455, USA.
| |
Collapse
|
4
|
AL-Omairi A, Alfarsi A. Hypomagnesemia-Induced Seizures Post Severe Acute Kidney Injury. Cureus 2022; 14:e26142. [PMID: 35891828 PMCID: PMC9301612 DOI: 10.7759/cureus.26142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 11/21/2022] Open
Abstract
Acute kidney injury (AKI) is a common complication in children admitted to pediatric intensive care units. It is known to be associated with increased morbidity and mortality. Here, we report prolonged, transient, increased renal magnesium (Mg) wasting after severe acute kidney injury presenting with a generalized tonic-clonic seizure.
Collapse
|
5
|
Moslehi M, Arab A, Shadnoush M, Hajianfar H. The Association Between Serum Magnesium and Premenstrual Syndrome: a Systematic Review and Meta-Analysis of Observational Studies. Biol Trace Elem Res 2019; 192:145-152. [PMID: 30880352 DOI: 10.1007/s12011-019-01672-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 02/07/2019] [Indexed: 12/22/2022]
Abstract
A number of studies have assessed the association between serum magnesium (Mg) and premenstrual syndrome (PMS) in different population, but the findings have been inconclusive. Herein, we systematically reviewed available observational studies to elucidate the overall relationship between Mg and PMS. PubMed, Cochrane's library, ScienceDirect, Scopus, Google Scholar, and ISI web of science databases were searched for all available literature until January 2019 for studies evaluating the association between Mg and PMS. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of observational studies. A total of 13 studies out of 196 met our inclusion criteria and were included in our systematic review and meta-analysis. There were no associations between serum magnesium and PMS (WMD - 0.04; 95% CI, - 0.14 to 0.06; P = 0.46) during follicular or serum/erythrocyte magnesium (WMD - 0.37; 95% CI, - 1.01 to 0.27; P = 0.25)/(WMD - 0.04; 95% CI, - 0.10 to 0.03; P = 0.26) and during luteal phase except for the sub-group of studies done outside of the US in which recent association became significant and means that serum Mg is lower in PMS subjects. According to what have been discussed, although our study did not show any significant association between serum/erythrocyte Mg and PMS except for serum Mg in luteal phase in the sub-group of studies done outside of the USA, heterogeneity between studies should be taken into accounts when interpreting these results. Additional well-designed clinical trials should be considered in future research to develop firm conclusions on the efficacy of magnesium on PMS.Registration number: CRD42018114473 .
Collapse
Affiliation(s)
- Mohsen Moslehi
- Skin Diseases and Leishmaniasis Research Center, Isfahan University Medical Sciences, Isfahan, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdi Shadnoush
- Department of Clinical Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Hajianfar
- Food Safety Research Center (SALT), Semnan University of Medical Sciences and Health Service, Semnan, Iran.
- Nutrition Department, Faculty of Nutrition and Food Science, Semnan University of Medical Sciences and Health Service, Semnan, Iran.
| |
Collapse
|
6
|
Kirkland AE, Sarlo GL, Holton KF. The Role of Magnesium in Neurological Disorders. Nutrients 2018; 10:E730. [PMID: 29882776 PMCID: PMC6024559 DOI: 10.3390/nu10060730] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/30/2018] [Accepted: 06/04/2018] [Indexed: 12/14/2022] Open
Abstract
Magnesium is well known for its diverse actions within the human body. From a neurological standpoint, magnesium plays an essential role in nerve transmission and neuromuscular conduction. It also functions in a protective role against excessive excitation that can lead to neuronal cell death (excitotoxicity), and has been implicated in multiple neurological disorders. Due to these important functions within the nervous system, magnesium is a mineral of intense interest for the potential prevention and treatment of neurological disorders. Current literature is reviewed for migraine, chronic pain, epilepsy, Alzheimer’s, Parkinson’s, and stroke, as well as the commonly comorbid conditions of anxiety and depression. Previous reviews and meta-analyses are used to set the scene for magnesium research across neurological conditions, while current research is reviewed in greater detail to update the literature and demonstrate the progress (or lack thereof) in the field. There is strong data to suggest a role for magnesium in migraine and depression, and emerging data to suggest a protective effect of magnesium for chronic pain, anxiety, and stroke. More research is needed on magnesium as an adjunct treatment in epilepsy, and to further clarify its role in Alzheimer’s and Parkinson’s. Overall, the mechanistic attributes of magnesium in neurological diseases connote the macromineral as a potential target for neurological disease prevention and treatment.
Collapse
Affiliation(s)
- Anna E Kirkland
- Department of Psychology, Behavior, Cognition and Neuroscience Program, American University, Washington, DC 20016, USA.
| | - Gabrielle L Sarlo
- Department of Psychology, Behavior, Cognition and Neuroscience Program, American University, Washington, DC 20016, USA.
| | - Kathleen F Holton
- Department of Health Studies, American University, Washington, DC 20016, USA.
- Center for Behavioral Neuroscience, American University, Washington, DC 20016, USA.
| |
Collapse
|
7
|
Chen BB, Prasad C, Kobrzynski M, Campbell C, Filler G. Seizures Related to Hypomagnesemia: A Case Series and Review of the Literature. Child Neurol Open 2016; 3:2329048X16674834. [PMID: 28503619 PMCID: PMC5417264 DOI: 10.1177/2329048x16674834] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 09/13/2016] [Accepted: 09/22/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Childhood seizures have various nonneurological etiologies. The patient's magnesium levels should be measured when evaluating afebrile seizures. The purpose of the current case series is to describe a systematic approach for diagnosing hypomagnesemia using 3 recent patient cases. METHODS This case series describes 3 patients with unprovoked hypomagnesemia-associated seizures. The authors describe the differential diagnosis, pathophysiology, and the workup of hypomagnesemia-associated seizures. RESULTS Hypomagnesemia contributed to the cause of the seizures in all 3 cases. Various causes of hypomagnesemia were investigated, including genetic etiologies. All 3 patients were maintained at a magnesium level >0.65 mmol/L, which improved or eliminated the seizures. SIGNIFICANCE Magnesium levels should always be measured when trying to determine the etiology of seizures. Hypomagnesemia and afebrile seizures should be treated with the goal of maintaining a magnesium concentration >0.65 mmol/L. Although rare, genetic causes of hypomagnesemia should be considered, once common causes of hypomagnesemia are ruled out.
Collapse
Affiliation(s)
- Becky Biqi Chen
- Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Chitra Prasad
- Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
| | - Marta Kobrzynski
- Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Craig Campbell
- Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Department of Epidemiology and Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Guido Filler
- Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| |
Collapse
|
8
|
Association of Serum Trace Elements and Minerals with Genetic Generalized Epilepsy and Idiopathic Intractable Epilepsy. Neurochem Res 2014; 39:2370-6. [DOI: 10.1007/s11064-014-1439-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 09/13/2014] [Accepted: 09/16/2014] [Indexed: 11/08/2022]
|
9
|
Gitelman Syndrome in a School Boy Who Presented with Generalized Convulsion and Had a R642H/R642W Mutation in the SLC12A3 Gene. Case Rep Pediatr 2014; 2014:279389. [PMID: 25140267 PMCID: PMC4124700 DOI: 10.1155/2014/279389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/06/2014] [Accepted: 06/12/2014] [Indexed: 12/15/2022] Open
Abstract
An 8-year-old Japanese boy presented with a generalized convulsion. He had hypokalemia (serum K 2.4 mEq/L), hypomagnesemia, and metabolic alkalosis (BE 5.7 mmol/L). In addition, his plasma renin activity was elevated. He was tentatively diagnosed with epilepsy on the basis of the electroencephalogram findings and was treated by potassium L-aspartate and carbamazepine to control the hypokalemia and seizure, respectively. However, a year later, the patient continued to have similar abnormal laboratory data. A presumptive diagnosis of Gitelman syndrome (GS) was then made and the patient's peripheral blood mononuclear cells were subjected to sequence analysis of the SLC12A3 gene, which encodes a thiazide-sensitive sodium-chloride cotransporter. The patient was found to have compound heterozygous mutations, namely, R642H inherited from his father and R642W inherited from his mother. Thus, if a patient shows persistent hypokalemia and metabolic alkalosis, GS must be considered, even if the patient exhibits atypical clinical symptoms.
Collapse
|
10
|
|
11
|
Yuen AW, Sander JW. Can magnesium supplementation reduce seizures in people with epilepsy? A hypothesis. Epilepsy Res 2012; 100:152-6. [DOI: 10.1016/j.eplepsyres.2012.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 01/31/2012] [Accepted: 02/05/2012] [Indexed: 12/15/2022]
|
12
|
Prolonged QT Syndrome and Seizure Secondary to Alkaline Earth Metal Deficiency: A Case Report. Case Rep Med 2011; 2011:863029. [PMID: 21822437 PMCID: PMC3138113 DOI: 10.1155/2011/863029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 05/20/2011] [Accepted: 05/20/2011] [Indexed: 11/18/2022] Open
Abstract
Introduction. Alkaline earth metal deficiency is recognized as a cause of both seizure and long QT syndrome. Their deficiency can have significant repercussions on the function of cells, tissues, and organs of the body. An understanding of the role of electrolytes allows an appreciation of the significance of depleted levels on cell function. Case Report. A 65-year-old lady was admitted with symptoms of chest discomfort, vomiting, increased stoma output, and dizziness. Two days following admission she suffered a tonic-clonic seizure. ECG review demonstrated a prolonged QTc interval, raising the possibility of an underlying Torsades de Pointes as the precipitant. This was attributed to electrolyte disturbance arising as a result of multiple aetiologies. Discussion. This paper highlights the multisystem effects of electrolyte disturbance, with emphasis upon its role in precipitating cardiac arrhythmia and neurological symptoms.
Collapse
|
13
|
A Surprising Etiology of Neonatal Seizures. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2010. [DOI: 10.1016/j.cpem.2010.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
14
|
Lee SW, Chung SS. A review of the effects of vitamins and other dietary supplements on seizure activity. Epilepsy Behav 2010; 18:139-50. [PMID: 20493778 DOI: 10.1016/j.yebeh.2010.04.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 04/11/2010] [Accepted: 04/13/2010] [Indexed: 11/30/2022]
Abstract
The role of pharmacological and surgical management of epilepsy continues to expand, but these treatments are often associated with significant side effects and morbidity. As a result, many patients with epilepsy and their physicians alike have gained interest in the role of vitamins and other dietary supplements for seizure management. In this review, we examine the potential anticonvulsant and proconvulsant effects of commonly used dietary supplements, as well as their potential effects on cognition or behavior. Our review was conducted through a literature search focusing on clinical trials involving patients with epilepsy and their seizure response to dietary supplementation. We summarize findings from previous clinical studies and comment on practical considerations regarding dietary supplementation for patients with epilepsy.
Collapse
Affiliation(s)
- Susan W Lee
- Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
| | | |
Collapse
|
15
|
Khine K, Rosenstein DL, Elin RJ, Niemela JE, Schmidt PJ, Rubinow DR. Magnesium (mg) retention and mood effects after intravenous mg infusion in premenstrual dysphoric disorder. Biol Psychiatry 2006; 59:327-33. [PMID: 16197921 PMCID: PMC1509101 DOI: 10.1016/j.biopsych.2005.07.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Revised: 06/16/2005] [Accepted: 07/11/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND Conflicting data exist regarding the presence of magnesium (Mg) deficiency and the therapeutic efficacy of Mg in premenstrual syndrome or premenstrual dysphoric disorder (PMDD). METHODS The % Mg retention was determined using 24-hour urinary Mg excretion and the total dose of Mg given intravenously. In women with (n = 17) and without (n = 14) prospectively diagnosed PMDD, several blood measures of Mg and mood were obtained before, immediately after, and the day following an intravenous Mg (.1 mmol/kg) loading dose. A positive mood response was seen under open conditions; as open Mg infusion improved mood, subsequent PMDD patients (n = 10) were randomized in a double-blind, placebo-controlled, crossover fashion. RESULTS Patients (31.5%) and control subjects (27.5%) retained comparable mean percentages of Mg. Neither group differed in measures of mean Mg before, immediately after, or the day following Mg infusion. Although there was a time effect for all mood measures in the patient group (p < .01 for all), there was neither a treatment nor time-by-treatment effect. CONCLUSIONS Contrary to prior reports, we found no evidence of Mg deficiency in women with PMDD compared with control subjects. Furthermore, Mg was not superior to placebo in the mitigation of mood symptoms in women with PMDD.
Collapse
Affiliation(s)
- Khursheed Khine
- Behavioral Endocrinology Branch, National Institute of Mental Health, National Institute of Health, Department of Health and Human Services, Bethesda, Maryland 20892-1277, USA.
| | | | | | | | | | | |
Collapse
|
16
|
Dharnidharka VR, Carney PR. Isolated idiopathic hypomagnesemia presenting as aphasia and seizures. Pediatr Neurol 2005; 33:61-5. [PMID: 15876516 DOI: 10.1016/j.pediatrneurol.2005.02.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2004] [Revised: 03/09/2004] [Accepted: 02/07/2005] [Indexed: 11/26/2022]
Abstract
Isolated hypomagnesemia of the idiopathic form is a rare condition that is known to present as generalized motor seizures in children. This report describes a 4-year-old African-American male who presented with a predominant symptom of sudden onset aphasia and no clear initial motor seizure activity. An evaluation revealed an isolated and severe hypomagnesemia (initial serum magnesium levels <1.0 mg/dL) and inappropriate renal handling of magnesium (fractional excretion of magnesium >40% under conditions of hypomagnesemia). The child had subsequent generalized tonic-clonic seizures that were brought under control with valproic acid therapy and magnesium supplementation. Six months after the diagnosis, he had regained 50-60% of his speech and had no further staring spells or motor seizure activity after the initial episode. Isolated and idiopathic hypomagnesemia caused by defective renal reabsorption of magnesium is a rare familial condition with variable inheritance. Aphasia as the solitary presenting symptom has not been described before. The exact pathophysiology of hypomagnesemic aphasia and seizures is not known but may relate to disinhibition of specific types of glutamate receptors. In the present case, neuronal depolarization may have been localized to language areas in the temporal lobes.
Collapse
Affiliation(s)
- Vikas R Dharnidharka
- Division of Pediatric Nephrology, University of Florida College of Medicine, Gainesville, FL 32610-0296, USA
| | | |
Collapse
|
17
|
Ishiguchi T, Mikita N, Iwata T, Nakata H, Sato H, Higashimoto Y, Fujimoto H, Yoshida S, Itoh H. Myoclonus and metabolic alkalosis from licorice in antacid. Intern Med 2004; 43:59-62. [PMID: 14964581 DOI: 10.2169/internalmedicine.43.59] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 90-year-old woman with hypertension developed metabolic alkalosis and myoclonus. Her medications included diltiazem hydrochloride, benidipine hydrochloride, kallidinogenase, procaterol hydrochloride, sennoside, dihydrocodeine phosphate, and KM powder antacid that contained 354 mg of licorice and 900 mg of sodium bicarbonate per 3.9 g of powder. Endocrinological studies showed slightly reduced plasma renin activity and normal plasma aldosterone concentration. A provisional diagnosis of licorice-induced metabolic alkalosis was established and the patient was successfully treated after correction of serum pH and cessation of the medications. Licorice-induced metabolic alkalosis must be considered in the differential diagnosis of myoclonus.
Collapse
Affiliation(s)
- Tadashi Ishiguchi
- Department of Internal Medicine, Wakayama Medical University Kihoku Hospital, Ito-gun, Wakayama
| | | | | | | | | | | | | | | | | |
Collapse
|