"Classics in ECT" brings you this review by William Karliner from 1978:
ECT for patients with CNS disease.
Karliner W.Psychosomatics. 1978 Dec;19(12):781-3. doi: 10.1016/S0033-3182(78)70896-0.PMID: 734033
Written by the great trailblazing ECT practitioner, William Karliner, this review appeared in Psychosomatics in 1978. The overall message, that safe ECT may be possible despite the presence of neurologic disease, is well taken. The cases are mostly from a time before brain imaging (except pneumo encephalograms) and are not necessarily examples of how current practice would assess these situations; also, the promotion of the "drip method" of ECT anesthesia, without full details of the technique, seems a bit strange. The recommendation of liberal oxygen use is a good one.A full read, ~10 minutes, makes the reader appreciate the efficacy and safety of ECT, and the fact that modern practitioners have much better tools to diagnose neurological disease.
The below comment is from Dr. Max Fink:
ReplyDelete“William Karliner was one of my teachers. He was a neurologist who treated his patients with maintenance treatment. He opposed the common practice of assigning patients to a fixed number —6, 8, 12— treatments. During my residency in 1952 and for some years afterwards I worked in his clinic Saturday mornings. Patients and family members were seen by him and if treatment was warranted they were sent to the treatment unit where I induced the seizures. Bill Karliner graduated from the University of Vienna, left Vienna as Hitler invaded Austria. He was the nephew of Manfred Sakel and treated patients by insulin coma. If patients did not show some response by 10 comas he induced seizures concurrently with the coma. He developed the use of flurothyl by inhalation and by IV. He was an outstanding clinician and researcher. His obituary is published in JECT 2005; 21:201-2.
Max Fink, MD