A prospective pilot study was undertaken to investigate the ability of magnesium sulphate to control the spasms of severe tetanus without the need for sedation and artificial ventilation. All eight patients admitted with severe tetanus to our intensive care unit within the last year were given magnesium sulphate 5 g i.v. as a loading dose followed by an infusion of 2-3 g/h. The infusion rate was increased to control spasms while retaining the patella tendon reflex, which proved an effective guide to overdose. Spasms were effectively controlled and serum magnesium concentrations were maintained within the therapeutic range. Spontaneous ventilation was adequate, ventilatory support being provided only for the management of lung pathology. There was no evidence of cardiovascular instability due to sympathetic over activity. No supplementary sedation was required for the control of spasms or autonomic dysfunction during magnesium therapy.
We conclude that magnesium sulphate can be used as the sole agent for the control of spasms in tetanus without the need for sedation and artificial ventilation.
Magnesium is a physiological calcium antagonist and there is a significant correlation between depression of neuromuscular transmission and serum magnesium concentrations. The fact that these effects are dose dependent and controllable is a great advantage over muscle relaxants. Magnesium is utilized in the control of spasms in eclampsia and the safety of the therapeutic range (2-4 mmols/l) has been well established as areflexia only occurs at levels above 4 mmol/l and muscle paralysis above 6 mmol/l.
Measuring magnesium levels in the blood plasma will often fail to demonstrate low levels, although RBC magnesium levels have been shown to be low in PMS sufferers.  Therefore, women who want to have a true picture of their magnesium levels should be encouraged to have a RBC magnesium level done. Estrogen enhances the utilization of magnesium. However, if estrogen levels are high, which is often the case with PMS, and magnesium intake is less then optimal, estrogen-induced shifts of magnesium can be deleterious, leading to muscle spasms, migraine, and other PMS disorders.  In one study serum levels of magnesium were inversely related to the serum level of estrogen. 
Magnesium supplementation can help alleviate many measurable parameters of PMS, including cramps, irritability, fatigue, depression and water retention.   Magnesium citrate, gluconate, and lactate are better absorbed than magnesium oxide. Magnesium glycinate is a well absorbed form, with minimum laxative effects.
Dosage: 300mg-400mg/day. Natural health care practitioners often recommend higher doses until symptoms are alleviated. Doses should be spread out throughout the day to avoid laxative effects. Supplementation with Vitamin B-6, along with magnesium, can help to increase cellular uptake of magnesium. 
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