ECT in patients with psychopathology related to acute neurologic illness

Psychiatrists are occasionally called upon to assist in the management of patients with severe psychopathologic syndromes resulting from acute neurologic illness. In the absence of other options for treating the underlying neurological disorder or with persistence of the psychopathology after resolution of the neurologic illness, electroconvulsive therapy (ECT) may be considered. The authors treated four such patients, two of whom experienced no benefit and two of whom experienced dramatic benefit. The authors provide recommendations for the approach to acutely ill neurologic patients with regard to the use of ECT.