It is important to eliminate cerebrovascular diseases following a first seizure in the elderly. Electrolyte disturbances can also cause epileptic seizures in this population. We aimed in this report to describe a first seizure in an elderly woman caused by an electrolyte disturbance: hypomagnesemia. A 58-year-old female patient admitted to our emergency clinic with generalized myoclonus. Monoparesis of her right limb was noted. She had a history of hypertension, diabetes, cardiac failure, and myocardial infarction. Her medical therapy involved diuretics and oral antidiabetics. Her brain imagings and lumbar puncture did not show any sign of cerebrovascular diseases and she had no systemic illness. Attempts with two antiepileptic drugs failed to control her seizures. In her routine blood samples, magnesium level was 1.26 mg/dl, so magnesium was replaced parenterally and then orally. Her seizures resolved after the magnesium level attained normal ranges. The EEG findings also returned to normal. In conclusion, every patient with a first epileptic seizure should be evaluated for electrolyte disturbances.Especially patients with comorbid diseases on polytherapy should be investigated with respect to hypomagnesemia.
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