Electroconvulsive Therapy and Severe Osteoporosis: Use of a Nerve Stimulator to Assess Paralysis

An elderly patient at high risk for fractures due to severe osteoporosis and other spinal pathology was treated with electroconvulsive therapy (ECT). Suppression of twitch response to peripheral nerve stimulation over the ulnar nerve was a more accurate monitor of degree of paralysis than other clinical indices. Complete paralysis was consistently achieved using this method. Successive doses of succinylcholine were not required with multiple treatments per session when the nerve stimulator was used to verify continued paralysis.