[Physical and electrophysiological aspects of electroconvulsive therapy--literature review]

Personnel and technical conditions for ECT (electroconvulsive therapy) is legally determined. In this article the author reviews studies focused on the technical questions of ECT. After the comparison of the unilateral and bilateral electrode placement an analysis is given on the physical properties of the stimulus used to elicit seizures. After discussing the questions of dose, wave-form frequency and polarity, the anatomical and physiological factors of impedance are evaluated. The author then discuss gender, age and encephalopathy as factors influencing seizure threshold. The connection between symmetry, regularity, and postictal suppression registered on the EEG and efficacy is observed. The EEG and EMG concordance is supposed to be connected also with the efficacy. In the discussion the author gives recommendations based on the literature.