Normo-Calcemic Tetany in a Patient with Hypokalemic Periodic Paralysis of Sjogren’s Syndrome: Neuromuscular Excitability Secondary to the ‘Forgotten Cation

A young lady, a known case of Sjogren’s syndrome, presented to our hospital with hypokalemic flaccid paralysis requiring ventilatory support. She was investigated and found to have severe hypokalemia and metabolic acidosis. During her hospitalization, she had severe persistent carpopedal spasm with normal ionized calcium. Following further evaluation, there was evidence of hypomagnesemia. The spasms were improved after her hypomagnesemia was corrected. This case report illustrate the role of hypomagnesemia in neurological abnormalities in hospitalized patients.