Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-25T11:56:07.880Z Has data issue: false hasContentIssue false

Is Electroencephalographic Monitoring of Electroconvulsive Therapy Clinically Useful?

Published online by Cambridge University Press:  02 January 2018

R. G. McCreadie*
Affiliation:
Crichton Royal Hospital, Dumfries DG1 4TG
K. Phillips
Affiliation:
Crichton Royal Hospital, Dumfries DG1 4TG
A. D. T. Robinson
Affiliation:
MRC Unit for Epidemiological Studies in Psychiatry, Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
G. Gilhooly
Affiliation:
The West of Scotland Health Boards, Department of Clinical Physics and Bioengineering, based at Dumfries and Galloway Royal Infirmary, Dumfries DG1 2BR
W. Crombie
Affiliation:
The West of Scotland Health Boards, Department of Clinical Physics and Bioengineering, based at Dumfries and Galloway Royal Infirmary, Dumfries DG1 2BR
*
Correspondence

Abstract

Electroencephalographic (EEG) monitoring was carried out in 169 bilateral and 114 unilateral applications of electroconvulsive therapy (ECT), given to 51 patients in an everyday setting within the National Health Service by junior medical staff. In 2.5% of bilateral and 8% of unilateral applications there was disagreement between clinical and EEG assessment as to whether a fit had occurred. When an EEG fit was said to have occurred only if it lasted longer than 25 seconds, then disagreement rose to 7% in bilateral and 28% in unilateral applications; disagreement was higher with unilateral applications, as they produced more short fits than bilateral applications. If future work shows duration of seizure is clearly associated with clinical efficacy, it is suggested the case for routine EEG monitoring is greatly strengthened.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1978) Task Force Report 14. Electroconvulsive therapy. Washington, DC, APA.Google Scholar
Christensen, P. & Koldbaek, I. (1982) EEG monitored ECT. British Journal of Psychiatry, 141, 1923.Google Scholar
Cooper, S. J., Kelly, J. G. & King, D. J. (1985) Adrenergic receptors in depression: effects of electroconvulsive therapy. British Journal of Psychiatry, 147, 2329.Google Scholar
Fink, M. & Johnson, L. (1982) Monitoring the duration of electroconvulsive therapy seizures. Archives of General Psychiatry, 39, 11891191.CrossRefGoogle ScholarPubMed
Horne, R. L., Pettinati, H. M., Sugerman, A. A., et al (1985) Comparing bilateral to unilateral electroconvulsive therapy in a randomised study with EEG monitoring. Archives of General Psychiatry, 42, 10871092.Google Scholar
Miller, A. L., Faber, R. A., Hatch, J. P., et al (1985) Factors affecting amnesia, seizure duration and efficacy in ECT. American Journal of Psychiatry, 142, 692696.Google Scholar
Pippard, J. & Ellam, L. (1981a) Electroconvulsive Treatment in Great Britain, 1980: a Report to the Royal College of Psychiatrists. London: Gaskell.Google Scholar
Pippard, J. & Ellam, L. (1981b) Electroconvulsive treatment in Great Britain. British Journal of Psychiatry, 139, 563568.Google Scholar
Rich, C. L. & Black, N. A. (1985) The efficacy of ECT: II Correlation of specific treatment variables to response rate in unilateral ECT. Psychiatry Research, 16, 147154.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases. Geneva: WHO.Google Scholar
Zorumski, C. F., Burke, W. J., Rutherford, J. L., et al (1986) ECT: clinical variables, seizure duration and outcome. Convulsive Therapy, 2, 109119.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.