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Case report
Stroke mimic in an acute rehabilitation unit patient with associated hypomagnesaemia
  1. Mia X Shan1,2,
  2. Andrew Hanna1,2,
  3. Emmanuel G Villalpando2 and
  4. Dixie Aragaki1,2
  1. 1Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
  2. 2David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
  1. Correspondence to Dr Mia X Shan; miaxinshan{at}gmail.com

Abstract

This case report describes a patient who presented with acute left facial numbness and eyelid weakness prompting work-up, which demonstrated low suspicion for new stroke but revealed hypomagnesaemia as a potential differential diagnosis. Patient initially presented to the emergency department with left upper extremity weakness and was diagnosed with right basal ganglia infarction. Two weeks after transfer to the acute rehabilitation unit, patient suddenly complained of left facial numbness and eyelid weakness. However, brain imaging did not show any new acute infarct. Instead, laboratory results showed hypomagnesaemia at 1.50 mg/dL. Patient was therefore treated with intravenous magnesium leading to resolution of his symptoms. Up to 30% of acute stroke presentations are stroke mimics. Although hypomagnesaemia is less frequently seen as a mimic, its neuromuscular manifestations may present with similar symptoms. Patients will always benefit from a comprehensive evaluation for stroke symptoms, but it is important to consider the mimics as well.

  • stroke
  • rehabilitation medicine
  • medical management

https://doi.org/10.1136/bcr-2020-239777

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    Footnotes

    • Contributors MXS was involved with informed consent, literature review, manuscript write-up and patient management. AH was involved in manuscript write-up and patient management. EV was involved in literature review and manuscript write-up. DA was involved with patient management and review of manuscript as the senior author.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.