A comparison of anticonvulsant efficacy and action mechanism of Mannitol vs Phenytoin in adult rat neocortical slices. (December 2017)

• Record Type: Journal Article
• Authors: Serafini, Ruggero
• Is Part Of: IBRO reports. Volume 3(2017)
• Page Start: 55
• Page End: 64
• Publication Date: 2017-12
• Subjects: Mannitol anticonvulsant effect -- Phenytoin anticonvulsant effect -- Adult neocortical epilepsy -- Multiple Electrodes Arrays; Nervous system -- Periodicals; Brain -- Periodicals; Brain -- Research -- Periodicals; Nervous system; Brain -- Research; Brain; Neurology; Nervous System Physiological Phenomena; Electronic journals; Periodicals; Fulltext; Internet Resources; Periodicals; Periodical
• DOI: 10.1016/j.ibror.2017.09.002
• Languages: English
• ISSNs: 2451-8301

Abstract

Highlights: In cortical slices addition of 30 mM Mannitol is anticonvulsant. Mannitol decreases the rate of epileptiform discharges. As an anticonvulsant Mannitol is as effective as Phenytoin. Mannitol is already used routinely in neurointensive care. Mannitol might be used in neurointensive care also as an anticonvulsant. Abstract: We show that, in adult rat neocortical slices, an anticonvulsant effect comparable to that of Phenytoin can be obtained through a Mannitol-induced increase in extracellular osmolarity of only 30 mOsm/L. The anticonvulsant action of extracellular hyperosmolarity has been known for decades but has not found a feasible therapeutic application, yet. A 30 mOsm/L increase in extracellular osmolarity is already utilized in neurocritical care though not as an anticonvulsant agent: the data suggest a possible effective anticonvulsant use, too, in this setting. We used multiple electrode arrays to characterize and compare the anticonvulsant mechanisms of Mannitol and Phenytoin. Phenytoin decreased the voltage, duration and spatial spread of rhythmic repetitive, ictal-like activity. In contrast, Mannitol did not significantly affect voltage, duration and spatial spread of rhythmic repetitive, ictal-like activity but rather it inhibited the rate of epileptiform discharges.