Electroconvulsive therapy and seizure: a double-edged sword?

Abstract

Electroconvulsive therapy (ECT) is a widely used therapeutic option of drug-refractory psychiatric disorders. ECT treats psychiatric symptoms by inducing brief controlled seizures through electrical stimulation, but ECT does not generally cause prolonged seizures or epilepsy. However, several studies have reported cases of prolonged seizures after ECT. This review aimed to determine the mechanism of epileptogenesis with neurobiological changes after ECT. Contrary to epileptogenesis by ECT, several cases have reported that ECT was successfully applied for treatment of refractory status epilepticus. In addition, ECT might be applied to hyperkinetic movement and psychiatric symptoms of encephalitis. We also investigated the anticonvulsant mechanism of ECT and how it controls encephalitis symptoms.

A case with temporal spikes on electroencephalography induced by over 80 sessions of electroconvulsive therapy

“…Some reports have demonstrated that the prevalence of spontaneous seizures after ECT ranged from approximately 1% to 2%, although a large 5‐year‐long study of psychiatric patients who received ECT showed no such cases. 4 In this article, we report a case with electroencephalography (EEG) abnormalities while undergoing over 80 sessions of ECT, contributing to the considerstion of measures to perform ECT safely.…”