Electroconvulsive Therapy in a Patient With Down Syndrome Regression Disorder and Inspire Device: A Case Report

Area of Science:

• Neurology
• Psychiatry

Background:

• Electroconvulsive therapy (ECT) is a primary treatment for catatonia.
• Implantable airway stimulation devices, like the Inspire system for obstructive sleep apnea (OSA), present unique challenges for ECT administration.
• Previous cases of ECT in patients with Inspire devices are limited.

Purpose of the Study:

• To describe the safe and effective use of ECT in a patient with catatonia secondary to Down syndrome regression disorder (DSRD) who had an implanted Inspire device.
• To provide practical guidance for managing ECT in patients with airway stimulators.

Main Methods:

• A 32-year-old male with autism spectrum disorder, epilepsy, OSA (treated with Inspire), and DSRD-associated catatonia underwent ECT.
• The Inspire device was turned off during ECT sessions, and electrodes were carefully positioned per manufacturer guidelines.
• The patient received 30 ECT treatments over 11 months.

Main Results:

• The patient showed significant improvement in speech, daily functioning, and a reduction in aggressive outbursts.
• No serious complications were observed during the ECT treatments.
• Standard medical treatments were ineffective or poorly tolerated.

Conclusions:

• ECT can be safely and effectively administered to patients with catatonia and implanted Inspire devices when appropriate precautions are taken.
• This case highlights the importance of managing ECT in patients with airway stimulators, a growing clinical consideration.