ECT in the treatment of status epilepticus
S H Lisanby1, C W Bazil, S R Resor
1Department of Biological Psychiatry, New York State Psychiatric Institute, New York 10032-2695, USA. SHL24@columbia.edu
Introduction:
Owing to its potent anticonvulsant actions, electroconvulsive therapy (ECT) has been proposed as an intervention for treatment-resistant seizure disorders.
Method:
We review the literature on the use of ECT in treatment-resistant epilepsy and status epilepticus (SE) and present a case of a patient who was in nonconvulsive SE for 26 days and then treated with ECT after all standard pharmacological strategies were exhausted. Because of skull defects, a novel electrode placement was used.
Results:
Owing to massively elevated seizure threshold attributable to concomitant anticonvulsant medications, extraordinarily high electrical dosage was needed for ECT to elicit generalized seizures. Status was terminated after three successful ECT-induced seizures. However, the long-term functional outcome of the patient was poor.
Discussion:
The role of ECT in the treatment algorithm for SE is discussed.
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