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December 1988

No, Magnesium Sulfate Should Not Be Used in Treating Eclamptic Seizures

Author Affiliations

From the Departments of Neurology and Neurosurgery (Drs Kaplan, Lesser, Fisher, and Hanley), Anesthesiology and Critical Care Medicine (Dr Hanley), and Gynecology/Obstetrics and Pediatrics (Dr Repke), Johns Hopkins University School of Medicine, Baltimore.

Arch Neurol. 1988;45(12):1361-1364. doi:10.1001/archneur.1988.00520360079017

It is curious that two medical specialities have adopted two entirely different approaches to the treatment of epileptic seizures, but this appears to be the case for eclampsia. In the modern pharmacologic armamentarium, the prophylaxis and treatment of seizures and status epilepticus by neurologists, neurosurgeons, and internists does not include the use of magnesium sulfate. Conversely, in obstetric practice, magnesium sulfate has long been the drug therapy of choice in preeclampsia and eclampsia in the United States.1 Ever since Lazard promoted the use of parenteral magnesium sulfate to control eclamptic seizures, little controversy has existed in the obstetric literature with respect to its use. Now that facilities exist for the rapid control of seizures, and therapy with anticonvulsant drugs with few side effects and known efficacy is available, the singular use of magnesium sulfate in the control of eclamptic seizures bears reexamination.

Eclampsia is a serious medical emergency in which

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