Abstract
Electroconvulsive therapy (ECT) is most frequently indicated for episodes of melancholic depression, but is also useful in the treatment of maniac syndrome and some schizophrenia subtypes. ECT is part of the treatment of movement disorders, neuroleptic malignant syndrome and even in the treatment of severe conversions. Although the therapeutic results are excellent when used appropriately, the mortality rate is estimated between 2 and 4 for 100,000 shocks. Despite this mortality rate, the benefit-risk ratio remains very positive and serious complications are extremely rare. ECT results in a biphasic cardiological effect: firstly a perstimulus parasympathetic hypertonia contemporary to the seizure's tonic phase, then a phase of contemporary sympathetic hypertonia during the epileptic clonic movement. We will focus on the perstimulus asystole as it is by far the most frequent. Very few cases and even less studies have been referenced in the literature; here, we present a clinical case followed by a discussion. The patient is in his fifties and has been treated for many years for a unipolar mood disorder with recurrent melancholic depressive episodes. With each new depressive episode, the clinical evolution is rapidly positive aft...Continue Reading
References
Mar 1, 1995·Anesthesia and Analgesia·I CastelliL J Drop
Mar 1, 1994·Journal of Internal Medicine·K R Kaufman
Jun 1, 1993·The American Journal of Psychiatry·R J ZielinskiH A Sackeim
Feb 1, 1996·The British Journal of Psychiatry : the Journal of Mental Science·A K JhaP Fenwick
Jul 11, 1998·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·J Burd, P Kettl
Dec 23, 1998·British Journal of Anaesthesia·P M MayurG S Rao
Jan 1, 1999·The Journal of ECT·P N DannonL Grunhaus
Jun 27, 2000·The Journal of ECT·J W FolkT A Duc
May 29, 2002·Journal of Clinical Anesthesia·Andrea GabrielliJerome H Modell
Aug 27, 2002·The Journal of ECT·Shyam K BhatConrad M Swartz
Feb 1, 2003·Epilepsia·R RocamoraC E Elger
Mar 19, 2003·Lancet·UNKNOWN UK ECT Review Group
Jun 26, 2004·Journal of Clinical Anesthesia·Marnie Robinson, Geoffery Lighthall
Feb 21, 2006·Annales Françaises D'anesthèsie Et De Rèanimation·B CharraS Motaouakkil
May 2, 2007·The British Journal of Psychiatry : the Journal of Mental Science·Trine Munk-OlsenRaben Rosenberg
Sep 4, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Elena J HolakPaul S Pagel
Apr 3, 2009·The New England Journal of Medicine·Anjala V Tess, Gerald W Smetana
Sep 16, 2009·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Stephan U Schuele
Nov 26, 2009·The Journal of ECT·Josef Nagler
Jan 6, 2011·The International Journal of Neuropsychopharmacology·Patrick T StewartDusan Hadzi-Pavlovic
Mar 3, 2012·L'Encéphale·A GaillardH Lôo
Aug 29, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·S MolliexH Beloeil