Phenytoin, phenobarbital, and midazolam fail to stop status epilepticus-like activity induced by low magnesium in rat entorhinal slices, but can prevent its development

Acta Neurol Scand. 1998 Sep;98(3):154-60. doi: 10.1111/j.1600-0404.1998.tb07286.x.

Abstract

It was shown previously that low-Mg2+-induced epileptiform activity in rat entorhinal cortex slices changes with time from a pattern of serial seizure-like events (SLEs) to a state of continuously recurring epileptiform activity. Valproic acid blocked the early SLEs but not the late activity. It was proposed that the late activity is a model for pharmacoresistant status epilepticus since it was also refractory to phenytoin, carbamazepine, phenobarbital, and midazolam. In the present study, it is demonstrated that phenytoin (50 microM, n=6), phenobarbital (150 microM, n=7), and midazolam (50 microM, n=5) were able to block the early SLEs but not the late activity at the same concentrations. Carbamazepine (50 microM) reduced the duration of the SLEs from 21 +/-5 s to 4+/-3 s (P<0.01), the interictal interval from 123+/-27 s to 27+/-19 s (P<0.01), the SLE-associated rise of [K+]o from 7.7+/-0.5 mM to 5.7+/-0.8 mM (n=4, P<0.05), and the spread of the SLE between entorhinal cortex and neocortex from 4.0+/-0.6 s to 0.8+/-0.1 s (n=4, P<0.05). Lower concentrations of phenytoin (5 and 10 microM, n=5), carbamazepine (10 microM, n =6), and phenobarbital (50 microM, n = 4) had no effect. In conclusion, the hypothesis is supported that low-Mg2+-induced epileptiform activity in rat entorhinal cortex is an in vitro model for the transition from pharmacosensitive to pharmacoresistant status epilepticus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anticonvulsants / pharmacology*
  • Carbamazepine / pharmacology
  • Culture Techniques
  • Dose-Response Relationship, Drug
  • Drug Resistance
  • Electroencephalography / drug effects
  • Entorhinal Cortex / drug effects*
  • Entorhinal Cortex / physiopathology
  • Magnesium / physiology*
  • Midazolam / pharmacology*
  • Phenobarbital / pharmacology*
  • Phenytoin / pharmacology*
  • Rats
  • Rats, Wistar
  • Status Epilepticus / physiopathology*

Substances

  • Anticonvulsants
  • Carbamazepine
  • Phenytoin
  • Magnesium
  • Midazolam
  • Phenobarbital