Magnesium sulfate for non-eclamptic status epilepticus
Magnesium sulfate for non-eclamptic status epilepticus
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DOI：
10.1016/j.seizure.2015.09.017
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发表时间：
2015-11
期刊：
影响因子：
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通讯作者：
Frederick A. Zeiler;M. Matuszczak;Jeanne Teitelbaum;L. Gillman;C. Kazina
中科院分区：
文献类型：
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作者：
Frederick A. Zeiler;M. Matuszczak;Jeanne Teitelbaum;L. Gillman;C. Kazina
背景我们的目标是对使用静脉内硫酸镁（MgSO 4）治疗非子痫性癫痫持续状态（SE）和难治性癫痫持续状态（RSE）的文献进行系统回顾。方法检索MEDLINE、BIOSIS、EMBASE、Global Health、Scopus、科克伦图书馆、国际临床试验注册平台、clinicaltrials.gov（开始至2015年6月）、相关文章参考列表和灰色文献。证据的强度裁定使用牛津和GRADE方法由两个独立的reviewers.ResultsWe确定了19篇原创文章。这些文章共描述了28例患者，其中11例为成人，9例为儿童，8例年龄未知。28例患者中有14例（50.0%）IV MgSO 4癫痫发作减少/控制，其中2例（7.1%）和12例（42.9%）分别显示部分和完全缓解。在SE/RSE降低/控制的患者中，50%的患者在停用MgSO 4治疗后癫痫复发。3例患者记录了与MgSO 4治疗相关的不良事件。结论Oxford 4级，D级证据表明，静脉注射MgSO 4治疗非子痫性RSE有改善癫痫控制的趋势。目前不建议常规使用静脉注射MgSO 4治疗非子痫SE/RSE。需要对这种药物进行进一步的前瞻性研究，以确定其在这种情况下作为抗癫痫药物的疗效。
BackgroundOur goal was to perform a systematic review of the literature on the use of intravenous magnesium sulfate (MgSO4) for non-eclamptic status epilepticus (SE) and refractory status epilepticus (RSE).MethodsArticles from MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library, the International Clinical Trials Registry Platform, clinicaltrials.gov (inception to June 2015), reference lists of relevant articles, and gray literature were searched. The strength of evidence was adjudicated using both the Oxford and GRADE methodology by two independent reviewers.ResultsWe identified 19 original articles. A total of 28 patients were described in these articles with 11 being adult, 9 being pediatric, and 8 of unknown age. Seizure reduction/control with IV MgSO4occurred in 14 of the 28 patients (50.0%), with 2 (7.1%) and 12 (42.9%) displaying partial and complete responses respectively. Seizures recurred upon withdrawal of MgSO4therapy in 50% of the patients whom had reduction/control of their SE/RSE. Three patients had recorded adverse events related to MgSO4therapy.ConclusionsOxford level 4, GRADE D evidence exists to suggest a trend towards improved seizure control with the use of intravenous MgSO4for non-eclamptic RSE. Routine use of IV MgSO4in non-eclamptic SE/RSE cannot be recommended at this time. Further prospective study of this drug is required in order to determine its efficacy as an anti-epileptic in this setting.