Electroconvulsive therapy and cerebral computed tomography. A prospective study

Cerebral computed tomography (CT) was performed before and after right-sided electroconvulsive therapy (ECT) in 40 patients aged 26-87 years with major affective disorders. Nine patients with a concomitant definite or possible non-acute organic brain disorder were included. Several patients had long seizure durations, maximum 6.5 min, caused by hyperventilation-induced hypocapnia. Twenty-nine patients received at least 16 treatments (maximum 46). No CT changes occurred following ECT. A questionable dilatation of the left temporal horn in a 69-year-old hypertensive man who recovered completely without side effects after 3 ECT sessions was probably unrelated to the ECT. Provided sufficient oxygenation, even relatively long ECT series and seizures lasting several minutes do not cause any brain damage visible on CT.