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Postictal neurogenic pulmonary edema: experience from an ECT model
S L Wayne1, C A O'Donovan, W V McCall
1Department of Neurology, North Carolina Baptist Hospital, Bowman Gray School of Medicine at Wake Forest University, Winston-Salem, North Carolina 27157, U.S.A.
Convulsive Therapy
|October 28, 1997
Summary
Neurogenic pulmonary edema (NPE) rarely occurs after seizures. This study found subclinical NPE is not common after electroconvulsive therapy (ECT)-induced seizures, limiting its use as a research model for epilepsy patients.
Area of Science:
- Neurology
- Pulmonology
- Critical Care Medicine
Background:
- Neurogenic pulmonary edema (NPE) is a rare complication after seizures, yet frequently observed post-mortem in epilepsy patients.
- A discrepancy exists between the low incidence of NPE after uncomplicated seizures and its high prevalence at autopsy.
- Subclinical NPE may occur transiently after seizures but is often undetected due to infrequent early radiographic assessment.
Purpose of the Study:
- To investigate the frequency of subclinical, radiographically confirmed NPE following electroconvulsive therapy (ECT)-induced seizures.
- To determine if ECT-induced seizures can serve as a reproducible model for studying NPE in epilepsy.
- To explore the heuristic value of an NPE model for understanding sudden unexplained death syndrome in epilepsy.
Main Methods:
- A pilot study involving 12 patients undergoing ECT for depression.
- Chest radiographs were obtained before and after ECT to detect subclinical NPE.
- Analysis focused on radiographic evidence of NPE in the post-ECT period.
Main Results:
- Only 1 out of 12 patients (8.3%) exhibited subclinical NPE on post-ECT chest radiographs.
- The findings suggest that subclinical NPE does not significantly occur after ECT-induced seizures.
Conclusions:
- Subclinical NPE is not a significant finding after seizures induced by ECT.
- ECT-induced seizures are unlikely to serve as a suitable model for studying NPE in epilepsy research.
- Further research is needed to fully understand the pathophysiology of NPE in epilepsy and its association with sudden death.