Failure of high-dose intravenous magnesium sulfate to control myoclonic status epilepticus

R. S. Fisher, P. W. Kaplan, A. Krumholz, R. P. Lesser, S. A. Rosen, M. R. Wolff

Research output: Contribution to journalArticlepeer-review

Abstract

An unsuccessful attempt to terminate myoclonic status epilepticus with elevation of serum magnesium levels is described. During 3 days, serum magnesium was increased from 1.5 mEq/L to 14.2 mEq/L by continuous i.v. infusion of 3-6 g/h of magnesium sulfate. Other anticonvulsants were maintained at nearly constant levels. Cerebrospinal fluid magnesium was 3.5 mEq/L during the infusion. Despite magnesium-related neuromuscular blockade and accompanying cessation of visible myoclonus, the electroencephalogram revealed ongoing blunted sharp-wave activity at the baseline frequency. Transient complications of the infusion included prolongation of the PR interval on the electrocardiogram, hypomotility of the gastrointestinal tract, and peripheral muscle flaccidity, all of which resolved within 24 h of return to normal serum magnesium levels. These results suggest that the therapeutic role of magnesium in myoclonic status epilepticus is limited.

Original languageEnglish (US)
Pages (from-to)537-544
Number of pages8
JournalClinical neuropharmacology
Volume11
Issue number6
DOIs
StatePublished - 1988

ASJC Scopus subject areas

  • Pharmacology
  • Clinical Neurology
  • Pharmacology (medical)

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