Dilemma in the emergency setting: hypomagnesemia mimicking acute stroke
نویسندگان
چکیده
BACKGROUND Stroke mimics may account for up to 30% of all acute stroke consultations. However, in the emergency setting, accurate diagnosis is not always possible. METHODS Case report and review of the literature. RESULTS A 73-year-old woman was admitted to the emergency department with acute aphasia and right hemiparesis. The National Institute of Health Stroke Score was 21, compatible with severe stroke, so she received thrombolysis. Laboratory testing demonstrated severe hypomagnesemia. She had been taking proton pump inhibitors for years and neuroimaging did not demonstrate signs of acute ischemic disease. After correcting the metabolic alterations with intravenous and oral supplemental magnesium, the patient was discharged asymptomatic. No further episodes have been registered to date. CONCLUSION Hypomagnesemia might cause acute neurological symptoms that could be confused with stroke. A careful history is essential for diagnosis but suspicion of stroke mimic should not prevent tPA administration.
منابع مشابه
Cardiovascular complications and acute ischemic stroke after the treatment with epinephrine in an anaphylactic patient
Anaphylaxis is a serious clinical condition that can affect all ages and many systems (skin, gastrointestinal system, respiratory and cardiovascular systems). There are a few case reports of cardiac and cerebrovascular complications due to the anaphylaxis and/or the treatment with epinephrine. A 69-year-old female patient with known coronary artery disease (CAD), coronary artery bypass graft (C...
متن کاملTo Determine the Frequency of Hypomagnesemia among patients with Acute Ischemic Stroke and to Study the Correlation of Serum Magnesium with Modified Rankin Scale After Acute Ischemic Stroke
Aim: The objective of this study is. “To determine the frequency of hypomagnesemia among patients with acute ischemic stroke and to study the correlation of serum magnesium with Modified Rankin Scale after acute ischemic stroke.” Study design: It is a cross sectional study. Setting: Indoor patients, departments of Medicine, Mayo Hospital, Lahore Duration of study:Six months from “15 th May 2014...
متن کاملسطح سرمی منیزیم و پیآمد بالینی خونریزی زیر عنکبوتیه آنوریسمال: مطالعه در 60 بیمار
Background: Hypomagnesemia is commonly encountered in patients with a wide variety of diseases including subarachnoid hemorrhage (SAH), cardiovascular emergencies, head trauma, migraine attacks, seizure and preeclampsia. It seems to be associated with a poor clinical outcome. This study considers the prevalence and temporal distribution of hypomagnesemia after aneurysmal SAH and its correlation...
متن کاملAcute Finger Paralysis: A Case Report of Cortical Ischemic Stroke
Somatotopic distribution of motor cortex and sensory fibers is theoretically fully understood. We present a case of stroke, mimicking peripheral palsy, with finger paralysis attributed to cortical lesion. The patient’s brain MRI may be useful to further understand the somatotopic representation of fingers in precentral and postcentral gyrus.
متن کاملAcute Phase Reactants as a Prognostic Factor in Acute Stroke
Introduction: Elevated levels of CRP are present among patients at risk for further first-ever myocardial infarction and stroke. It has been shown that after ischemic stroke, increased levels of CRP are associated with unfavorable outcomes. Methods: From 120 patients admitted to the emergency unit of our hospital with the diagnosis of stroke CRP, D-dimer and ferritin level was measured and the ...
متن کامل