Zeiler F A, Matuszczak M, Teitelbaum J, Gillman L M, Kazina C J
Section of Neurosurgery, Dept. of Surgery, University of Manitoba, Winnipeg, Canada.
Undergraduate Medicine, University of Manitoba, Winnipeg, Canada.
Seizure. 2015 Nov;32:100-8. doi: 10.1016/j.seizure.2015.09.017. Epub 2015 Sep 28.
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).
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.
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.
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.
我们的目标是对静脉注射硫酸镁（MgSO4）用于非子痫性癫痫持续状态（SE）和难治性癫痫持续状态（RSE）的文献进行系统综述。
检索了MEDLINE、BIOSIS、EMBASE、全球健康、Scopus、Cochrane图书馆、国际临床试验注册平台、clinicaltrials.gov（从起始到2015年6月）、相关文章的参考文献列表以及灰色文献中的文章。由两名独立评审员使用牛津和GRADE方法判定证据强度。
我们确定了19篇原始文章。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%）静脉注射MgSO4后癫痫发作减少/得到控制，其中2例（7.1%）显示部分缓解，12例（42.9%）显示完全缓解。在SE/RSE得到减少/控制的患者中，50%在停用MgSO4治疗后癫痫复发。3例患者记录了与MgSO4治疗相关的不良事件。
存在牛津4级、GRADE D级证据表明，静脉注射MgSO4用于非子痫性RSE有癫痫控制改善的趋势。目前不建议在非子痫性SE/RSE中常规使用静脉注射MgSO4。需要对该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。
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