title: Recurrent confusional episodes associated with hypomagnesaemia due to esomeprazol.
abstract: In February 2011, the Food and Drug Administration informed that prescription of proton pump inhibitor (PPI) drugs may cause low serum magnesium levels if taken for prolonged periods of time. We present an ex-smoker, 76-year-old man, with high blood pressure, diabetes mellitus and Barrett's oesophagus (treated with esomeprazole since 2003) admitted due to fluctuating aphasia. Neurovascular and neuroimaging studies were normal. Dyslipidemia and atrial arrhythmia were discovered. The patient was discharged with the diagnosis of left middle cerebral artery transient ischaemic attack and anticoagulation treatment was recommended. The patient returned to the emergency department on further two occasions (confusional episodes) and was admitted in order to complete the neurological study that was normal. The patient was discharged with the diagnosis of probable epileptic seizures. After a week, he was admitted due to generalised temblor and unsteadiness. A complete blood test was performed and showed a severe hypomagnesaemia (not previously performed).
authors.affiliation: Neurology Service, Hospital Universitario Central de Asturias, Oviedo, Spain. mglezdelgado@yahoo.es
authors.forename: Montserrat G
authors.initials: MG
authors.lastname: Delgado
authors.forename: Sergio
authors.initials: S
authors.lastname: Calleja
authors.forename: Lorena
authors.initials: L
authors.lastname: Suarez
authors.forename: Julio
authors.initials: J
authors.lastname: Pascual
mesh_terms: D000368:Aged; D003221:Confusion / Q000139:chemically induced*; D064098:Esomeprazole / Q000009:adverse effects*; D006801:Humans; D008274:Magnesium / Q000097:blood*; D008297:Male; D008659:Metabolic Diseases / Q000139:chemically induced / Q000150:complications*; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012008:Recurrence
chemical_list: D054328:Proton Pump Inhibitors; D008274:Magnesium; D064098:Esomeprazole
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