Proton Pump Inhibitor Induced Hypomagnesemia Causing Seizures: A Rare Adverse Effect of a Commonly Used Medication.
Level 4 - case-series / case-control
Single clinical case report
PubMed 39114244 · doi:10.7759/cureus.64044
What was done
A case report detailing the presentation, laboratory workup, acute management, and outpatient follow-up of a 49-year-old male presenting with severe vomiting and generalized tonic-clonic seizures after chronic over-the-counter proton pump inhibitor (PPI) intake.
What was found
The patient, with a one-year history of pantoprazole use, had severe hypomagnesemia with a serum magnesium level of 0.1 mmol/L, along with marginal hypokalemia, hypophosphatemia, and hypocalcemia. Clinical condition improved after resuscitation and magnesium supplementation. Post-discharge self-administration of omeprazole 20 mg maintained marginal hypomagnesemia (0.5 mmol/L) without overt clinical symptoms until total PPI cessation was achieved.
Why it matters
It underscores that chronic, unmonitored over-the-counter PPI use can cause life-threatening electrolyte derangements and seizures, highlighting the need for thorough medication histories and patient education.
Limits
Single-patient case report (n=1) with no comparator or control group; cannot determine incidence, causality mechanisms, or population-level risk.
Cited by
- supports Severe magnesium deficiency (hypomagnesemia) in humans, which can be triggered by specific medications, can present with seizures and convulsions.