Electroconvulsive therapy and meningioma: a brief review

Accumulating clinical knowledge indicates that electroconvulsive therapy (ECT) can be used in patients with stable and small brain tumors without any sign of increasing intracranial pressure as long as the risks have been appropriately evaluated. However, there are no clear and detailed clinical guidelines for the application of ECT in patients with brain tumors. Severe complications are described in cases reported before 1980 when the definitive diagnosis of brain tumor before ECT was difficult. We reviewed 13 cases from the literature from the 1980s or later in which ECT was administered to psychiatric patients with a prior diagnosis of meningiomas, a very common type of tumor, before ECT. All cases responded to ECT. Among the cases reviewed, the largest meningioma was 3 x 3 cm. Minor complications such as headache and transient confusion were reported in 5 of 13 cases; however, no severe complications were observed. Accurate identification and careful evaluation of meningioma by routine neuroimaging and other advanced medical techniques surrounding the use of ECT have contributed to the decrease in severe complications.