Effect of Magnesium Sulphate on Optic Nerve Sheath Diameter as an Indirect Measure of Intra-Cranial Pressure: A Case Study of Eclampsia Patients

Background: Eclampsia is associated with increased intracranial pressure (ICP). Magnesium sulphate (MgSO4) is the usual treatment and is linked to a significant decrease in cerebral perfusion pressure (CPP) as well as the avoidance of brain injury. There are various invasive procedures which are still the gold standard for monitoring intracranial pressure (ICP), however, they are not always practical or easily available choices. Therefore, a non-invasive promising tool can be used to reflect variations in the intracranial pressure is optic nerve sheath diameter (ONSD) assessment using ultrasonography. Objective: This study aims to measure changes in the Optic nerve sheath diameter in order to identify the impact of magnesium sulphate treatment; a proxy for elevated intracranial pressure in eclampsia patients. Methods: In this pilot study the data was collected from sixty pregnant female patients with all signs and symptoms of eclampsia. The analysis of optic nerve sheath diameter was done using ultrasound prior to the start of magnesium sulphate treatment and then was measured after 01, 06 and 24 hours. Results: The mean diameter of optic nerve sheath in women was high at baseline time point and they were presented with hypertension and disturbed vision. At one, six and twenty-four hours of taking magnesium sulphate, there was a statistically significant decrease in the mean optic nerve sheath diameter values. However, there is insignificant relationship between mean arterial pressure and optic nerve sheath diameter. Conclusion: This study concludes that a high optic nerve sheath diameter value, indicative of elevated intracranial pressure, was present in the majority of study participants who were significantly eclamptic. This condition was significantly impacted by magnesium sulphate medication. Thus, ultrasound can be used as a convenient, affordable, point-of-care bedside technology to indirectly measure intracranial pressure in this high-risk group.