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A Continuing Controversy: Magnesium Sulfate in the Treatment of Eclamptic Seizures

Peter W. Kaplan, MB, BS, MRCP; Ronald P. Lesser, MD; Robert S. Fisher, MD, PhD; John T. Repke, MD; Daniel F. Hanley, MD
Arch Neurol. 1990;47(9):1031-1032. doi:10.1001/archneur.1990.00530090111021.
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We would like to address some of the issues raised by Pritchard1 and Lindheimer2 in their letters to the editor. Pritchard outlines a plan of treatment for eclampsia that includes parenteral magnesium sulfate, intravenous hydralazine, and the delivery of the baby; he is concerned that a proposal for a different treatment regimen for eclampsia would not be approved by a human subjects committee given the apparently satisfactory results of his treatment protocol. In his experience, magnesium sulfate "almost always stops convulsions promptly and prevents their recurrence," and he comments on the effect of magnesium sulfate: "some [believe] that it is not an anticonvulsant, presumably because the arrest of the convulsions and the prevention of their recurrence does not induce generalized central nervous system depression in mother or fetus." We wish to note, parenthetically, that an intrinsic property of anticonvulsant medication is not the induction of "generalized central nervous


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