Paroxysmal epileptiform discharges in temporal lobe slices after prolonged exposure to low magnesium are resistant to clinically used anticonvulsants.

Lowering of extracellular Mg2+ results in various forms of epileptiform activity in different parts of temporal lobe slices [5,22] which contain neocortical areas such as areas Te2 or Te3, the entorhinal cortex (EC), subiculum, hippocampal areas CA1 to CA3 and the dentate gyrus [5,11]. In the EC, the subiculum and Te2/Te3 seizure-like events (SLEs) with tonic and clonic electrographic discharge patterns, negative slow field potentials and ionic changes comparable to those during tonic-clonic seizures in intact animals were observed. After 30 to 120 min of recurrent seizure activity (80 +/- 37 min) the seizure-like events (SLEs) developed into a state of late recurrent discharges (LRDs). Since previous studies had shown that the LRDs do not respond to valproic acid in contrast to a blocking effect of this drug on SLEs, we investigated the effects of the clinically employed anticonvulsants phenytoin, carbamazepine, phenobarbital, midazolam and ethosuximide on LRDs. All these agents were unable to block the LRDs in the EC, subiculum and Te2/Te3. This was found true both for concentrations which can block SLEs and for higher concentrations. Thus we conclude that this activity may represent a model of difficult to treat status epilepticus.