Maintaining electroconvulsive therapy for refractory epilepsy combined with psychotic symptoms

Electroconvulsive therapy (ECT) is an effective treatment for many psychiatric conditions. However, using ECT to treat epilepsy is controversial. We present this case of a patient who had epilepsy and combined psychiatric symptoms, including irritable mood, aggressiveness, refusal of food intake and non-cooperation with medical care. Her brain CT revealed massive brain lesions. After ECT, she became dramatically more cooperative, less aggressive and ate food and took her medication. In addition, no spontaneous seizure was noted after ECT. However, when we stopped ECT, the previous symptoms gradually reappeared. We therefore regularly administered ECT once or twice a week to maintain the patient's stable condition. We suggest that ECT may be considered for maintenance of the patient with epilepsy who is refractory or uncooperative to other treatment.