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

[+] Author Affiliations

Accepted for publication March 14, 1990.

Reprint requests to Department of Neurology, Francis Scott Key Medical Center, 4940 Eastern Ave, Baltimore, MD 21224 (Dr Kaplan).

Arch Neurol. 1990;47(9):1031-1032. doi:10.1001/archneur.1990.00530090111021

Text Size: A A A

Published online

Article

References

Comments

ABSTRACT

ABSTRACT | REFERENCES

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

REFERENCES

ABSTRACT | REFERENCES

Pritchard JA. Magnesium sulfate in the treatment of eclampsia . Arch Neurol . 1989;;46:947-948.

Lindheimer MD. Magnesium sulfate and preeclampsia or eclampsia . Arch Neurol . 1989;;46:1164-1165.

Slater RM, Smith WD, Patrick J, et al. Phenytoin infusion in severe pre-eclampsia . Lancet . 1987;;2:1417-1420.

Moosa SM, El Zayat SG. Phenytoin infusion in severe pre-eclampsia . Lancet . 1987;;2:1147-1148.

Massei R, DeSilva E, Grosso P, et al. Cerebral protection with dephenylhydantoin during disobliteration surgery of the supra-aortic branches . J Neurosurg Sci . 1983;;27:107-110.

Bremer AM, Yamada K, West CR. Ischemic cerebral edema in primates: effects of acetazolamide, phenytoin, sorbitol, dexamethasone and methylprednisolone on brain water and electrolytes . Neurosurgery . 1980;;6:149-154.

Mick BA. Diphenylhydantoin and intermittent edema . JAMA . 1973;;225:1533.

Repke JT, Friedman SA, Lim KH, Baker CA. Magnesium sulfate versus phenytoin in pre-eclampsia: preliminary results from a randomized clinical trial. Read before the ninth annual meeting of the Society of Perinatal Obstetricians; February 1-4, 1989; New Orleans, La. Abstract 112.

Ryan G, Lange I, Naugler M. Clinical experience using phenytoin prophylaxis in severe pre-eclampsia (PET). Read before the ninth annual meeting of the Society of Perinatal Obstetricians; February 1-4, 1989; New Orleans, La. Abstract 127.

Goldman RS, Finkbeiner SM. Therapeutic use of magnesium sulfate in selected cases of cerebral ischemia and seizure . N Engl J Med . 1988;;319:1224-1225.

Sadeh M. Action of magnesium sulfate in the treatment of preeclampsia-eclampsia . Stroke . 1989;;20:1273-1275.

Krauss GL, Kaplan P, Fisher RS. Parenteral magnesium sulfate fails to control electroshock and pentylenetetrazol seizures in mice . Epilepsy Res . 1989;;4:201-206.

Fisher RS, Kaplan PW, Krumholtz A, Lesser RP, Rosen SA, Wolff MR. Failure of high-dose intravenous magnesium sulfate to control myoclonic status epilepticus . Clin Neuropharmacol . 1988;;11:537-544.

Management of preeclampsia. Am Coll Obstet Gynecol Tech Bull . (February) 1986;;91:1-6.

Pritchard JA. Eclampsia: OB/GYN Life-threatening Emergencies . Raritan, NJ: Ortho Pharmaceutical Corp; 1985;:1-28.

Kaplan PW, Lesser RP, Fisher RS, Repke JT, Hanley DF. No, magnesium sulfate should not be used in treating eclamptic seizures . Arch Neurol . 1988;;45:1361-1363.

Hachinski V. Magnesium sulfate in the treatment of eclampsia . Arch Neurol . 1988;;45:1364.

First Page Preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal