Magnesium sulfate for control of muscle rigidity and spasms and avoidance of mechanical ventilation in pediatric tetanus.
OBJECTIVE
To describe the use of intravenous magnesium sulfate for the control of muscle spasms and severe generalized rigidity in a child with moderate to severe tetanus without the need for prolonged deep sedation, mechanical ventilation, or neuromuscular blockade.


METHODS
Case report.


METHODS
Pediatric intensive care unit in a tertiary care, university-based children's hospital.


METHODS
A continuous infusion of magnesium sulfate.


RESULTS
We describe a 12-yr-old child with moderate to severe tetanus who was treated with a continuous infusion of magnesium sulfate to control painful muscle spasms and severe generalized rigidity initially refractory to moderate sedation. Muscle spasms and severe generalized rigidity were improved with magnesium sulfate. No adverse effects associated with the use of magnesium sulfate were noted during the monitoring of cardiovascular and respiratory function, reflexes, and serum magnesium concentrations.


CONCLUSIONS
An infusion of magnesium sulfate can be utilized to treat muscle spasms and severe generalized rigidity without the need for deep sedation, mechanical ventilation, or neuromuscular blockade. We recommend that magnesium sulfate be considered in the armamentarium of therapeutics utilized to treat muscle spasms and rigidity associated with tetanus, provided the patient's neurologic, cardiovascular, and respiratory status can be closely monitored in the pediatric intensive care unit.
Ceneviva
Gary D
GD
Divisions of Pediatric Critical Care Medicine, Penn State Children's Hospital, Penn State University College of Medicine, Hershey, PA, USA.
Thomas
Neal J
NJ
Kees-Folts
Deborah
D
D002648:Child; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D009127:Muscle Rigidity / Q000209:etiology / Q000517:prevention & control*; D012121:Respiration, Artificial; D013035:Spasm / Q000209:etiology / Q000517:prevention & control*; D013742:Tetanus / Q000150:complications*
D008278:Magnesium Sulfate