Hypermagnesemia-induced fatality following epsom salt gargles(1)

J Emerg Med. 2002 Feb;22(2):185-8. doi: 10.1016/s0736-4679(01)00462-0.


Hypermagnesemia is a rare cause of coma in a patient with normal renal function. When present, it is often because of iatrogenic medication overdose. We report a fatal case of chronic Epsom salt gargles for halitosis that produced a serum magnesium of 23.6 mg/dL (9.8 mmol/L) and resulted in coma. We review the wide presentation of hypermagnesemia from subtle neurologic and cardiovascular signs to the major life-threatening clinical manifestations of shock, dysrhythmias, coma, and cardiopulmonary arrest despite emergency dialysis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Chemical Analysis
  • Coma / etiology
  • Fatal Outcome
  • Female
  • Halitosis / drug therapy
  • Humans
  • Magnesium / blood*
  • Magnesium Sulfate / poisoning*
  • Nonprescription Drugs / poisoning*
  • Poisoning / complications
  • Poisoning / diagnosis


  • Nonprescription Drugs
  • Magnesium Sulfate
  • Magnesium