What are the initial signs and symptoms of hypomagnesemia?

Updated: Oct 30, 2020
  • Author: Tibor Fulop, MD, PhD, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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The earliest manifestations of magnesium deficiency are usually neuromuscular and neuropsychiatric disturbances, the most common being hyperexcitability. Neuromuscular irritability, including tremor, fasciculations, tetany, Chvostek and Trousseau signs, and convulsions, has been noted when hypomagnesemia has been induced in volunteers. Other manifestations include the following:

  • Convulsions
  • Apathy
  • Muscle cramps
  • Hyperreflexia
  • Acute organic brain syndromes
  • Depression
  • Generalized weakness
  • Anorexia
  • Vomiting

Magnesium is required for stabilization of the axon. The threshold of axon stimulation is decreased and nerve conduction velocity is increased when serum magnesium is reduced, leading to an increase in the excitability of muscles and nerves. The cellular basis for these changes is due to increased intracellular calcium content, by mechanisms similar to those described above for hypertension.

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