Intravenous magnesium in non-eclamptic seizures

Report By: Helen Turner - SpR Emergency Medicine
Search checked by Helen Turner - SpR Emergency Medicine
Institution: Royal Blackburn Hospital
Date Submitted: 17th November 2007
Last Modified: 17th November 2007
Status: Blue (submitted but not checked)

Three Part Question

In [a patient in non-eclamptic status epilepticus] is [intravenous magnesium] effective at [terminating seizure activity]

Clinical Scenario

While on duty in the emergency department a 35 year old known idiopathic epileptic is brought in in status epilepticus. After 2 benzodiazepine doses and intravenous phenytoin the seizure activity continues. You wonder if intravenous magnesium may be helpful in terminating the siezure.

Search Strategy

Ovid Medline 1966 - November 2007
[exp Magnesium Chloride/ or exp Magnesium/ or exp Magnesium Sulfate/ or magnesium.mp. or exp Magnesium Compounds/] AND [status epilepticus.mp. or exp Status Epilepticus/ or exp Seizures/ or seizure$.mp. or convulsion$.mp. or exp Epilepsy/ or fit$.mp]

Search Outcome

1698 papers identified, none relevant to the 3 part question

Comment(s)

Intravenous magnesium is widely used in preventing and terminating eclamptic seizures. There is in vitro evidence of magnesium rich solutions stabilising seizure activity in neurones but no clinical evidence in non-eclamptic seizures.

Clinical Bottom Line

No proven benefit