# Unraveling the Puzzle: A Case of Intricate Neurological Presentation Attributable to Hypomagnesemia

## TL;DR

This paper presents a rare case where severe neurological symptoms were caused by low magnesium levels without an obvious underlying condition.

## Contribution

The novelty lies in highlighting hypomagnesemia as a primary cause of neurological deficits without typical renal or gastrointestinal pathology.

## Key findings

- A 48-year-old male presented with severe neurological symptoms due to hypomagnesemia.
- No renal, gastrointestinal, hormonal, infectious, or autoimmune pathology was found.
- The case emphasizes the need to consider hypomagnesemia in ICU neurological presentations.

## Abstract

Hypomagnesemia can occasionally present with severe neurological deficiencies, and it is usually attributed to an underlying renal and/or gastrointestinal pathology. Rarely, patients may present with neurological symptoms in the absence of an obvious cause. Our case highlights the importance of considering hypomagnesemia as a primary cause of those presenting with severe neurological deficits in an intensive care unit setting, as well as the significance of conducting a thorough social and medical history on these patients to elucidate their underlying causes. We discuss the case of a 48-year-old Caucasian male who acutely presented with seizures, tremors, visual hallucinations, diplopia, personality changes, and ataxia with recurring severely low magnesium (0.4 mg/dL) at times in the absence of renal, gastrointestinal, hormonal, infectious, or autoimmune pathology.