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Dysphagia and Vertical Nystagmus in Magnesium Deficiency

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Oklahoma City Veterans Administration Hospital and University of Oklahoma Health Sciences Center; Oklahoma City, Oklahoma

Ann Intern Med. 1978;89(2):222-223. doi:10.7326/0003-4819-89-2-222
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Magnesium deficiency should be anticipated as a complication in patients with extensive intestinal resections (short-bowel syndrome) (1-2). In man, it produces neuromuscular hyperexcitability with muscle weakness, tremors, athetoid movements, and fasciculations (3). Tetany, generalized tonic-clonic or focal seizures, and positive Chvostek's signs also may be present. Some patients develop irritability, depression, and even psychotic behavior. In patients with experimentally-induced magnesium deficiency, abnormal electromyograms were consistently observed with short-duration, rapid-firing myopathic potentials (3). The peripheral effects of magnesium are to decrease liberation of acetylcholine at the neuromuscular junction and sympathetic ganglia; magnesium deficiency is associated with an increase in neuronal excitability


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