Acute Flaccid Quadriparesis caused by hypermagnesemia

Abstract

We report a case of Acute Flaccid Quadriparesis
due to hypermagnesemia resulting
from the unsupervised use of high
doses of magnesium sulphate administered
as a part of Pitchards regimen to a
woman to control postpartum seizures.
The treatment was given in a peripheral
hospital for the seizures following the delivery
by LSCS. She was known to have
Pregnancy Induced Hypertension (PIH)
during antenatal period.Magnesium level
was not monitored and also the reflexes
were not periodically checked during the
magnesium therapy.Hypermagnesemia
is an uncommon but serious side effect
of the use of Magnesium containing compounds.
Magnesium therapy is usually
safe if used in appropriate dosages and
with normal renal function. Here the renal
status of the patient was not known and
liberal use of magnesium led to the deterioration
of the level of conscious and
weakness of all four limbs and referred to
the tertiary hospital. She was found to
have hypermagnesemia due to renal failure
and after haemodialysis she recovered
well. This case report serves to illustrate
the characteristic
pathophysiologic changes of severe hypermagnesemia
an entity rarely seen in obstetric
practice. More importantly it alerts
obstetricians to be aware of complications
of magnesium therapy and importance of
monitoring magnesium level.