ABSTRACT
We report the case of a 27-year-old man with mild-moderate intellectual disability (ID) and bipolar disorder treated with electroconvulsive therapy (ECT). He was psychiatrically hospitalized for agitation, aggression, and manic symptoms including insomnia, rapid and pressured speech, and hyperactivity. After multiple medication trials, ECT was recommended. The treatment was delayed owing to the need to obtain evaluation for incapacity and then substituted consent from the patient's mother. He received 2 ECT treatments with marked improvement but complicated by transient fevers, which resolved without treatment. Fever workup was unremarkable. The patient became calm and cooperative and was discharged home. He was readmitted 3 weeks later, again in an agitated manic state. He received 5 additional ECT treatments, but this time with no post-ECT fevers. Once again, his manic symptoms resolved, and he was safely discharged. Whereas patients with ID pose special challenges, our case is in keeping with the previous literature, which supports the use of ECT in patients with ID and comorbid psychiatric disorders.
Subject(s)
Bipolar Disorder/therapy , Electroconvulsive Therapy/adverse effects , Fever/etiology , Intellectual Disability/complications , Adult , Bipolar Disorder/complications , Female , Humans , Treatment OutcomeABSTRACT
We report the case of a 50-year-old man who exhibited transient left hemiparesis (Todd's paralysis) after electroconvulsive therapy, which completely resolved within 10 minutes. Subsequent neurological evaluation was unremarkable for discrete etiologies for this event, other than Todd's paralysis. We review the literature of this phenomenon in association with electroconvulsive therapy.
Subject(s)
Depressive Disorder, Major/complications , Depressive Disorder, Major/therapy , Electroconvulsive Therapy/adverse effects , Paralysis/etiology , Paresis/etiology , Anesthesia , Antidepressive Agents/therapeutic use , Depressive Disorder, Major/psychology , Electroencephalography , Humans , Male , Middle Aged , Neurologic Examination , Tomography, X-Ray ComputedABSTRACT
We present the case of a 69-year-old woman with psychotic depression who suffered a non-ST segment elevation myocardial infarction at her first electroconvulsive therapy (ECT). Her course of ECT was resumed 19 days later, and she was able to complete it without further problems. Her depression remitted fully. We report the details of her cardiac management during subsequent treatment sessions and review the literature on cardiac adverse events with ECT.