—We would like to thank Brorson for his comments regarding the continuing controversy about the use of magnesium sulfate in the treatment of eclamptic seizures,1 and take this opportunity to respond to his remarks.The magnesium ion is known to play a role in blocking the cation channel associated with the N-methyl-d-aspartate (NMDA) receptor subtype of the glutamate receptor.2 It is, therefore, not surprising that NMDA antagonists disrupt development or expression of epileptiform activity induced by low magnesium concentrations.3 Reduction of ambient magnesium in bathing medium of in vitro model systems for epilepsy can induce epileptiform activity,4 and low serum magnesium concentrations can lead to convulsions.5 Nevertheless, these observations do not necessarily imply that magnesium sulfate would be therapeutic for clinical seizures. Magnesium has a special relationship to seizures mediated by the NMDA system; magnesium may not be as effective
Fisher RS, Kaplan PW, Lesser RP, Repke J, Hanley D. Magnesium Suppresses Seizurelike Discharges in Cultured Neurons-Reply. Arch Neurol. 1991;48(7):677–678. doi:10.1001/archneur.1991.00530190019006
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