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Reconsidering the seizure threshold? A retrospective study about seizure quality among patients with maintenance ECT
- Source :
- Acta neuropsychiatrica. 31(1)
- Publication Year :
- 2018
-
Abstract
- ObjectivesElectroconvulsive therapy (ECT) is a safe and validated technique used to treat various psychiatric conditions. It triggers an artificially-induced seizure. This seizure is defined using several parameters such as the amount of energy, duration, frequency, pulse width and intensity. Efficacy and adverse events depend on the amount of energy delivered. Due to technical control, the amount of energy delivered by our unit’s ECT device was limited to 614 mC, 60% of the maximum possible output of the device. We wondered if lowering the dose would lead to better seizure quality among maintenance ECT patients.MethodsWe assessed seizure quality based on the EEG, using a validated tool created by MacPherson. Two evaluators independently rated the seizures. Pre- and post-control scores were compared using Student’s t-test for paired samples.ResultsWe analysed data from 15 patients. Mean age was 65 years old. Twelve had depressive disorder, two had schizophrenia and one had schizo-affective disorder. Mean duration of seizure before control was 41.1 s [95% confidence interval (95CI)=26.1, 51.1]. The mean MacPherson’s score was 20.3 (95CI=16.2, 24.4). After control, the mean MacPherson’s score was 28.2 (23.1, 33.3), showing a significant difference with the pre-control dataset (p=0.032; t=−2.4; df=14). Specifically, peak mid-ictal amplitude increased from 6.9 (95CI=5.1, 8.7) to 10.0 (95CI=7.2, 12.8). Other sub-scores remained unchanged.ConclusionLowering the energy delivered led to an overall increase of seizure quality among our sample. This highlights the necessity and utility of retitration during ECT maintenance, possibly leading to better management of our patients.
- Subjects :
- Male
medicine.medical_treatment
Electroencephalography
03 medical and health sciences
0302 clinical medicine
Electroconvulsive therapy
Seizures
medicine
Secondary Prevention
Humans
Adverse effect
Electroconvulsive Therapy
Biological Psychiatry
Aged
Retrospective Studies
Depressive Disorder
medicine.diagnostic_test
Seizure threshold
business.industry
Retrospective cohort study
Middle Aged
medicine.disease
Confidence interval
030227 psychiatry
Psychiatry and Mental health
Psychotic Disorders
Schizophrenia
Anesthesia
Major depressive disorder
Female
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 16015215 and 09242708
- Volume :
- 31
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Acta neuropsychiatrica
- Accession number :
- edsair.doi.dedup.....fc2d825e6e2ccf6998b397c445853cde