ECT After Prolonged Seizure: Case Report From Michigan

Out on PubMed, from authors in Michigan, is this case report:


Efficacious retrial of electroconvulsive therapy for major depressive disorder after a prolonged seizure in an older adult.
Kramkowski J, Rath S.BMJ Case Rep. 2023 May 2;16(5):e247633. doi: 10.1136/bcr-2021-247633.

PMID: 37130644

The abstract is copied below:

This is a case of a woman in her 70s with treatment-resistant major depression who was admitted psychiatrically for the fifth time in 1.5 years. She had a history of intensive psychotherapy and psychotropic medication trials with poor efficacy. She also had a history of adverse complications to electroconvulsive therapy (ECT) with prolonged seizures and postictal confusion during her third hospitalisation. At her fifth hospitalisation, due to poor response to routine psychiatric treatment, ECT was pursued. We discuss challenges in pursuing ECT and the outcome of the retrial of an acute ECT series, in the context of a paucity of similar literature regarding geriatric depression.

Keywords: Mood disorders (including depression); Psychiatry; Psychiatry of old age.

The report is here.

And here:





This is a well-intended case report with a useful overall message. All the ECT details are in Figure 1, not in the text. With no EEG corroboration, it is hard to confirm what the patient's status (pun intended) really was, but the clinical scenario seems consistent with a prolonged seizure. The case report is also too long for the message, but I will assume an inexperienced author and give kudos for a good effort.

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