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Continuation of ECT after recovery from transient, ECT-induced, postictal cortical blindness
Sushma Sonavane1, Vivek Bambole, Abha Bang
1Department of Psychiatry, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India.
Background:
Transient, postictal cortical blindness is a rare adverse effect of electroconvulsive therapy (ECT). There is no information on the safety of continuation of ECT in patients who recover from ECT-induced cortical blindness.
Methods:
An 18-year-old woman with paranoid schizophrenia experienced cortical blindness immediately after her first bifrontotemporal ECT treatment. There was complete, spontaneous recovery of vision after 6 hours. Neurological examination, computed tomography of the brain, and electroencephalographic study revealed no abnormality. A combination of circumstances suggested that continuation of ECT was desirable. After clearances from neurological and ophthalmological teams, she received 6 more ECT treatments, starting 9 days after the first.
Results:
After resumption of ECT, there was marked improvement in psychopathology across the ECT course. There was no recurrence of visual symptoms.
Conclusions:
Patients who experience transient, ECT-induced, postictal cortical blindness may not necessarily experience the same adverse effect on rechallenge with ECT.
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