Preserved Cochlear Implant Function After Multiple Electroconvulsive Therapy Treatments

Abstract

This case report presents the successful use of multiple treatments of electroconvulsive therapy (ECT) in a patient with a cochlear implant (CI). A 60‐year‐old man with a left‐sided CI and bipolar disorder presented with severe depression. A total of 9 separate sessions of unilateral ECT was administered to the contralateral side of the existing CI. We collected subjective, clinical, and audiological assessment of the patient and the CI prior, during, and after ECT therapy. The patient tolerated ECT well and there were no complications. Unilateral ECT was performed contralateral to the CI without any harm to the patient or implant. Laryngoscope, 131:E1695–E1698, 2021

A Review Electroconvulsive Therapy in Cochlear Implant Patients

“…The case reported by Labadie et al 16 only received 2 ECT treatments. On contrary, in the case reports by Lauridsen, 14 Jiam et al, 15 and Veigne et al, 17 the number of ECT treatments ranged from 9 to 13, which resembles typical daily practice. This vaguely indicates that a broad patient group can receive a typical number of ECT treatments without complications.…”

“…The CI impedance measurements before, in between and after ECT, showed no damage to the electrodes. No patient harm was reported 15 …”

“…At ECT, the majority of the electrical current bypasses the brain and passes through the skin and skull, hence providing a theoretically risk of current induced damage to the CI. To reduce the risk of damaging the CI and the patient during ECT, the ECT electrodes were placed with greatest distance possible to the CI, hence contralaterally to the CI, in 3 [14][15][16] of the 4 reported cases. In the case report by Lauridsen, 14 the patient had a right-sided CI.…”

“…In the 3 case reports [14][15][16] in which ECT settings are described, charge ranged from 48 to 1004 mC, which is almost maximum charge on the used device. These settings reflect daily clinical practice and indicate that typical ECT settings do not harm CIs nor the CI users.…”

“…No patient harm was reported. 15 A 17-year-old adolescent male unilateral CI user (nucleus 22; Cochlear) presented with delirious mania, resistant to aggressive pharmacologic management. (The specific side of CI placement was not reported).…”