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Five percent CO₂ is a potent, fast-acting inhalation anticonvulsant.

Publication ,  Journal Article
Tolner, EA; Hochman, DW; Hassinen, P; Otáhal, J; Gaily, E; Haglund, MM; Kubová, H; Schuchmann, S; Vanhatalo, S; Kaila, K
Published in: Epilepsia
January 2011

PURPOSE: CO₂ has been long recognized for its anticonvulsant properties. We aimed to determine whether inhaling 5% CO₂ can be used to suppress seizures in epilepsy patients. The effect of CO₂ on cortical epileptic activity accompanying behavioral seizures was studied in rats and nonhuman primates, and based on these data, preliminary tests were carried out in humans. METHODS:   In freely moving rats, cortical afterdischarges paralleled by myoclonic convulsions were evoked by sensorimotor cortex stimulation. Five percent CO₂ was applied for 5 min, 3 min before stimulation. In macaque monkeys, hypercarbia was induced by hypoventilation while seizure activity was electrically or chemically evoked in the sensorimotor cortex. Seven patients with drug-resistant partial epilepsy were examined with video-EEG (electroencephalography) and received 5% CO₂ in medical carbogen shortly after electrographic seizure onset. RESULTS: In rats, 5% CO₂ strongly suppressed cortical afterdischarges, by approximately 75%, whereas responses to single-pulse stimulation were reduced by about 15% only. In macaques, increasing pCO₂) from 37 to 44-45 mm Hg (corresponding to inhalation of 5% CO₂ or less) suppressed stimulation-induced cortical afterdischarges by about 70% and single, bicuculline-induced epileptiform spikes by approximately 25%. In a pilot trial carried out in seven patients, a rapid termination of electrographic seizures was seen despite the fact that the application of 5% CO₂ was started after seizure generalization. CONCLUSIONS: Five percent CO₂ has a fast and potent anticonvulsant action. The present data suggest that medical carbogen with 5% CO₂ can be used for acute treatment to suppress seizures in epilepsy patients.

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Published In

Epilepsia

DOI

EISSN

1528-1167

Publication Date

January 2011

Volume

52

Issue

1

Start / End Page

104 / 114

Location

United States

Related Subject Headings

  • Young Adult
  • Time Factors
  • Seizures
  • Rats, Wistar
  • Rats
  • Pilot Projects
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Macaca nemestrina
 

Citation

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Tolner, E. A., Hochman, D. W., Hassinen, P., Otáhal, J., Gaily, E., Haglund, M. M., … Kaila, K. (2011). Five percent CO₂ is a potent, fast-acting inhalation anticonvulsant. Epilepsia, 52(1), 104–114. https://doi.org/10.1111/j.1528-1167.2010.02731.x
Tolner, Else A., Daryl W. Hochman, Pekka Hassinen, Jakub Otáhal, Eija Gaily, Michael M. Haglund, Hana Kubová, Sebastian Schuchmann, Sampsa Vanhatalo, and Kai Kaila. “Five percent CO₂ is a potent, fast-acting inhalation anticonvulsant.Epilepsia 52, no. 1 (January 2011): 104–14. https://doi.org/10.1111/j.1528-1167.2010.02731.x.
Tolner EA, Hochman DW, Hassinen P, Otáhal J, Gaily E, Haglund MM, et al. Five percent CO₂ is a potent, fast-acting inhalation anticonvulsant. Epilepsia. 2011 Jan;52(1):104–14.
Tolner, Else A., et al. “Five percent CO₂ is a potent, fast-acting inhalation anticonvulsant.Epilepsia, vol. 52, no. 1, Jan. 2011, pp. 104–14. Pubmed, doi:10.1111/j.1528-1167.2010.02731.x.
Tolner EA, Hochman DW, Hassinen P, Otáhal J, Gaily E, Haglund MM, Kubová H, Schuchmann S, Vanhatalo S, Kaila K. Five percent CO₂ is a potent, fast-acting inhalation anticonvulsant. Epilepsia. 2011 Jan;52(1):104–114.
Journal cover image

Published In

Epilepsia

DOI

EISSN

1528-1167

Publication Date

January 2011

Volume

52

Issue

1

Start / End Page

104 / 114

Location

United States

Related Subject Headings

  • Young Adult
  • Time Factors
  • Seizures
  • Rats, Wistar
  • Rats
  • Pilot Projects
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Macaca nemestrina