title: Magnesium sulfate for non-eclamptic status epilepticus.
abstract: BACKGROUND
  Our 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).
  
  
  METHODS
  Articles 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.
  
  
  RESULTS
  We 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 MgSO4 occurred 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 MgSO4 therapy in 50% of the patients whom had reduction/control of their SE/RSE. Three patients had recorded adverse events related to MgSO4 therapy.
  
  
  CONCLUSIONS
  Oxford level 4, GRADE D evidence exists to suggest a trend towards improved seizure control with the use of intravenous MgSO4 for non-eclamptic RSE. Routine use of IV MgSO4 in 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.
authors.affiliation: Section of Neurosurgery, Dept. of Surgery, University of Manitoba, Winnipeg, Canada. Electronic address: umzeiler@myumanitoba.ca.
authors.forename: F A
authors.initials: FA
authors.lastname: Zeiler
authors.affiliation: Undergraduate Medicine, University of Manitoba, Winnipeg, Canada. Electronic address: matuszcm@myumanitoba.ca.
authors.forename: M
authors.initials: M
authors.lastname: Matuszczak
authors.affiliation: Section of Neurology, Montreal Neurological Institute, McGill, Montreal, Canada. Electronic address: jteitelbaum@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Teitelbaum
authors.affiliation: Section of Critical Care Medicine, Dept. of Medicine, University of Manitoba, Winnipeg, Canada; Section of General Surgery, Dept. of Surgery, University of Manitoba, Winnipeg, Canada. Electronic address: gillmanlm@gmail.com.
authors.forename: L M
authors.initials: LM
authors.lastname: Gillman
authors.affiliation: Section of Neurosurgery, Dept. of Surgery, University of Manitoba, Winnipeg, Canada. Electronic address: ckazina@exchange.hsc.mb.ca.
authors.forename: C J
authors.initials: CJ
authors.lastname: Kazina
mesh_terms: D061605:Administration, Intravenous; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008278:Magnesium Sulfate / Q000008:administration & dosage* / Q000009:adverse effects; D013226:Status Epilepticus / Q000188:drug therapy*
chemical_list: D000927:Anticonvulsants; D008278:Magnesium Sulfate
keywords: Magnesium sulfate (MgSO(4)); Refractory status epilepticus; Status epilepticus