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Acute embolic stroke after electroconvulsive therapy.

Kiwon Lee1

  • 1Vascular and Critical Care Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.

The Journal of ECT
|April 25, 2006
PubMed
Summary
This summary is machine-generated.

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A rare case of acute stroke occurred immediately after electroconvulsive therapy (ECT) in a patient with depression. Prompt thrombolytic therapy led to rapid recovery, highlighting effective treatment options for this uncommon event.

Area of Science:

  • Neurology
  • Cardiology
  • Psychiatry

Background:

  • Electroconvulsive therapy (ECT) is a psychiatric treatment with a generally favorable safety profile.
  • Neurological complications from ECT are rare, with most common side effects including headache and disorientation.
  • This case examines an unusual neurological event following ECT.

Observation:

  • A 44-year-old woman experienced an acute stroke with left-sided hemiplegia and dysarthria immediately after an electroconvulsive therapy (ECT) session.
  • Imaging revealed a clot in the right middle cerebral artery (MCA) (distal M1 segment).
  • The patient presented with a National Institutes of Health Stroke Scale score of 14.

Findings:

  • The patient received prompt intravenous and intra-arterial thrombolysis with recombinant tissue plasminogen activator (rt-PA).

Related Experiment Videos

  • Successful recanalization of the MCA was achieved, leading to rapid neurological improvement within 24 hours.
  • Extensive workup did not identify a specific cause for the stroke or hypercoagulable risk factors.

    • Implications:

    • This case underscores the possibility of acute stroke following ECT, although extremely rare.
    • It demonstrates the effectiveness of aggressive thrombolytic therapy, including intra-arterial rt-PA, in managing MCA occlusions.
    • While a direct causal link remains unclear, this report highlights the importance of vigilance and timely intervention for stroke in patients undergoing ECT.