ECT in the Presence of Brain Tumor-Literature review
Out on PubMed, from investigators in Prague, Czech Republic, is this review:
Brain Tumors and Electroconvulsive Therapy: A Literature Overview of the Last 80 Years.
Front Neurol. 2020 Jul 31;11:723. doi: 10.3389/fneur.2020.00723. eCollection 2020.PMID: 32849199
The abstract is copied below:
The safety and efficacy of electroconvulsive therapy (ECT) in patients with a brain tumor have been debated in the past without a clear conclusion. In the last large review published by Maltbie et al. in 1980, it was concluded that the presence of an intracranial mass should be considered an absolute contraindication to ECT. In our updated review, we investigated a total of 33 published and indexed case reports, case report series, and reviews of 75 individual patients who underwent ECT in the presence of a brain tumor over the last 80 years. Mounting case reports after the original Maltbie et al. review show that it is feasible to apply this method safely in patients with benign or otherwise clinically insignificant lesions. Certain precautionary measures, such as dexamethasone or phenytoin application before ECT, could lead to a further minimalization or even absence of adverse effects, particularly in higher risk individuals.
The pdf is here.
This is a useful update on the literature of the use of ECT in patients with brain tumors. The conclusion of the need to assess risk on an individual case basis, is reasonable. Of course, the issue is that the term "brain tumor" covers a wide spectrum of lesions, differing in size, type and effect on neighboring CNS structures. This review is worth reading by ECT practitioners, so that they can be up to date on the literature evidence base about patients who present with this uncommon, but not rare, co-morbidity.
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