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ECT and Neurological Disorders.

John K. Hsiao1, John A. Messenheimer, Dwight L. Evans

  • 1Department of Psychiatry, University of North Carolina, School of Medicine, Chapel Hill, North Carolina; and Section on Clinical Pharmacology, Laboratory of Clinical Science, National Institute of Mental Health, Bethesda, Maryland, USA.

Convulsive Therapy
|January 1, 1987
PubMed
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Electroconvulsive therapy (ECT) can be used in patients with neurological disorders, but requires careful consideration of risks like increased intracranial pressure. Many neurological conditions do not contraindicate ECT, and some, like Parkinson's disease, may even benefit.

Area of Science:

  • Neurology
  • Psychiatry

Background:

  • Electroconvulsive therapy (ECT) is a treatment that can cause significant physiological changes.
  • Clinicians express concern when considering ECT for patients with pre-existing neurological disorders.

Purpose of the Study:

  • To review the existing literature on the use of ECT in patients with various neurological conditions.
  • To identify specific neurological disorders that may pose risks or contraindications for ECT.

Main Methods:

  • Systematic review of reported cases and studies involving ECT in patients with neurological diseases.
  • Analysis of physiological effects of ECT, including blood pressure, cerebral blood flow, and intracranial pressure.

Main Results:

  • Space-occupying lesions, cerebral aneurysms, recent head trauma, and active CNS infections are associated with increased risks due to ECT-induced physiological changes.

Related Experiment Videos

  • Epilepsy and conditions lowering seizure threshold may lead to prolonged seizures during ECT.
  • History of head injury or stroke does not significantly increase ECT risk.
  • Toxic/metabolic disorders are not absolute contraindications, but require correction of the underlying imbalance.
  • Extrapyramidal, demyelinating, and neuromuscular disorders generally pose minimal additional risk.
  • ECT may offer benefits for motor symptoms in Parkinson's Disease.

    • Conclusions:

    • ECT can be cautiously considered in most neurological disorders.
    • Careful management of physiological changes and underlying conditions is crucial for safe ECT administration.
    • Treating the primary neurological disorder before initiating ECT is generally advisable.