MRI-negative cerebellar syndrome caused by medication-induced magnesium deficiency: a case report

Electrolyte disorders as a reason for central nervous pathologies remain underdiagnosed and underestimated, as a heterogeneous clinical appearance, the growing number of defined cerebellar diseases and, like in our case, lacking imaging abnormality aggravatingly contrast with a high intake prevalence of triggering medication. The presence of diarrhea or vomiting, electrolyte shortage, cardiac arrhythmia, alcoholism and particularly the intake of proton pump inhibitors in patients with cerebellar symptoms should result in thorough electrolyte diagnostics. Early recognition of this causally treatable cerebellar syndrome and prompt discontinuation of triggering medication are crucial to improve the often poor prognosis.