A patient presenting with an acute cerebellar ataxia, nausea, and vomiting of approximately one week's duration was found to have a serum calcium of 23.7 mg/100 ml. This was attributed to calcium and vitamin D therapy following previous thyroidectomy on July 3, 1962. Immediately after baseline studies, 20 cc of 50% magnesium sulfate were administered intramuscularly. No further therapy was given. The neurologic findings, as well as the nausea and vomiting, resolved rapidly within 24 hours in conjunction with decreasing serum calcium levels which reached a normal level of 10.9 mg at the end of five days. The urinary calcium excretion in the first 24 hours following MgSO4 was elevated to 803 mg. The EEG changed from abnormal diffuse slow alpha activity to normal within four days. An elevated spinal fluid protein (58 mg%) returned toward normal (43 mg%) in approximately three weeks.
This is believed to be the
LYNCH HT, LEMON HM, HENN MJ, ELLINGSON RJ, GRISSOM RL. Vitamin D-Intoxicated Patient With HypoparathyroidismHypercalcemia, Acute Cerebellar Ataxia, and EEG Changes: Magnesium Sulfate Therapy. Arch Intern Med. 1964;114(3):375–380. doi:10.1001/archinte.1964.03860090109011
Customize your JAMA Network experience by selecting one or more topics from the list below.