We treated a case of iatrogenic hypermagnesemia that clinically mimicked a central brain-stem herniation syndrome. Hypermagnesemia (magnesium level, 9.85 mmol/L [24 mg/dL]) can cause parasympathetic blockade, inducing fixed and dilated pupils, in addition to neuromuscular blockade. Extreme hypermagnesemia can therefore mimic a midbrain syndrome and cause a pseudocomatose state.
(Arch Intern Med. 1993;153:1130-1132)
Rizzo MA, Fisher M, Lock JP. Hypermagnesemic Pseudocoma. Arch Intern Med. 1993;153(9):1130–1132. doi:10.1001/archinte.1993.00410090072009
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