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Migraine after electroconvulsive therapy
1Department of Psychiatry, University of Münster, Germany.
Convulsive Therapy
|September 1, 1995
Summary
Electroconvulsive therapy (ECT) can trigger common migraine attacks in patients with major depressive disorder. Switching anesthetics from methohexital to propofol stopped these recurrent migraines, suggesting propofol may inhibit seizure generalization.
Area of Science:
- Neurology
- Psychiatry
Background:
- Electroconvulsive therapy (ECT) is a treatment for major depressive disorder.
- Migraine is a common neurological disorder.
- The relationship between ECT and migraine is not well-established.
Observation:
- A 52-year-old woman with major depressive disorder experienced recurrent common migraine attacks following ECT.
- Her migraine symptoms were similar to her infrequent spontaneous attacks.
- The patient had methohexital intolerance, leading to a switch to propofol for anesthesia.
Findings:
- Migraine attacks ceased after the anesthetic was changed to propofol.
- Propofol may inhibit seizure generalization, potentially preventing ECT-induced migraines.
- ECT may trigger migraine attacks in susceptible individuals, similar to spontaneous seizures.
Implications:
- Clinicians should consider the potential for ECT to trigger migraines in patients with a history of migraine.
- Anesthetic choice, such as propofol, might mitigate ECT-associated migraine risk.
- Further research is needed to understand the mechanisms linking ECT, seizure generalization, and migraine.