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Would Monitoring by Electroencephalogram Improve the Practice of Electroconvulsive Therapy?

Published online by Cambridge University Press:  02 January 2018

Allan I. F. Scott ,
P. Anne Shering  and
Sheena Dykes
Allan I. F. Scott*
Affiliation:
University Department of Psychiatry, Royal Edinburgh Hospital
P. Anne Shering
Affiliation:
University Department of Psychiatry, Royal Edinburgh Hospital
Sheena Dykes
Affiliation:
University Department of Psychiatry, Royal Edinburgh Hospital
*
∗University Department of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
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Abstract

Estimates of seizure length made by the treating psychiatrist were compared with estimates made by six-channel EEG in 100 electroconvulsive treatments in 22 depressed patients. In 70 treatments the doctor observed a fit which was shorter than 25 seconds. No doctor restimulated a patient in such a case and on only three occasions was the electrical stimulus increased at the next treatment. EEG monitoring revealed that only 30 of the treatments resulted in a seizure of less than 25 seconds, and this was detected in almost all cases by the treating doctor. The potential value of EEG monitoring was to identify patients whose visible seizure was short but where cerebral seizure length was satisfactory. Trainee psychiatrists often mismanage patients who have short seizures.

Type
Papers
Information
The British Journal of Psychiatry , Volume 154 , Issue 6 , June 1989 , pp. 853 - 857
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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References

Addersley, D. & Hamilton, M. (1953) Use of succinylcholine in ECT. British Medical Journal, i 195–197.Google Scholar
American Psychiatric Association (1978) Electroconvulsive Therapy. Report of the task force on electroconvulsive therapy of the American Psychiatric Association. Washington DC: APA.Google Scholar
Bhatnagar, K. S. (1987) ECT practice-failed seizures. Bulletin of the Royal College of Psychiatrists, 11, 382–383.CrossRefGoogle Scholar
Brumback, R. A. (1983) EEG monitoring of ECT. British Journal of Psychiatry, 142, 104–105.CrossRefGoogle ScholarPubMed
Christensen, P. & Koldbaek, L. B. (1982) EEG monitored ECT. British Journal of Psychiatry, 141, 19–23.Google Scholar
Daniel, W. F. (1983) How does ECT work? British Journal of Psychiatry, 142, 536–539.Google Scholar
D'Elia, G., Ottosson, J-O. & Stromgren, L. S. (1983) Present practice of electroconvulsive therapy in Scandinavia. Archives of General Psychiatry, 20, 577–581.Google Scholar
Fink, M. (1979) Convulsive Therapy: Theory and Practice. New York: Raven Press.Google Scholar
Fink, M. (1987) New technology in convulsive therapy: a challenge in training. American Journal of Psychiatry, 144, 1195–1198.Google Scholar
Ives, J. O., Weever, L. A. & Williams, R. (1976) Portable electromyograph monitoring of unilateral ECT. American Journal of Psychiatry, 133, 1340–1341.Google ScholarPubMed
Kendell, R. E. (1981) The present status of electroconvulsive therapy. British Journal of Psychiatry, 139, 265–283.Google Scholar
Kramer, B. A. (1983) Seizure parameters in depressed patients receiving electroconvulsive therapy: a pilot study. Comprehensive Psychiatry, 24, 259–261.Google Scholar
Lancet (1981) ECT in Britain: a shameful state of affairs. Lancet, ii 1207–1208.Google Scholar
Larson, G., Swartz, C. & Abrams, R. (1984) Duration of ECT-induced tachycardia as a measure of seizure length. American Journal of Psychiatry, 141, 1269–1271.Google ScholarPubMed
Maletzky, B. M. (1978) Seizure duration and clinical effect in electroconvulsive therapy. Comprehensive Psychiatry, 19, 541–555.Google Scholar
Martin, J. H. (1985) Cortical neurones, the EEG and the mechanism of epilepsy. In Principles of Neuroscience (2nd edn) (eds Kandel, E. R. & Schwartz, J. H.). Oxford: Elsevier.Google Scholar
Ottosson, J-O. (1962) Seizure characteristics and therapeutic efficiency in electroconvulsive therapy: an analysis of the antidepressant efficiency of grand mal and lidocaine-modified seizures. Journal of Mental and Nervous Disease, 135, 239–251.Google Scholar
Pippard, J. (1986) Electroconvulsive therapy in Great Britain, 1981 follow-up. Convulsive Therapy, 2, 62–64.Google Scholar
Pippard, J. & Ellam, L. (1981) Electroconvulsive treatment in Great Britain. British Journal of Psychiatry, 139, 563–568.Google Scholar
Pippard, J. & West, E. (1987) ECT practice. Bulletin of the Royal College of Psychiatrists, 11, 101.Google Scholar
Rich, C. L. & Black, N. A. (1985) The efficiency of ECT: II. Correlation of specific treatment variables to response rate in unilateral ECT. Psychiatry Research, 16, 107–154.CrossRefGoogle ScholarPubMed
Ries, R. (1985) Poor interrater reliability of MECTA EGG seizure duration measurement during ECT. Biological Psychiatry, 20, 94–98.CrossRefGoogle Scholar
Snaith, R. P. & Simpson, K. (1987) ECT practice. Bulletin of the Royal College of Psychiatrists, 11, 203.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research Diagnostic Criteria; rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Warmflash, V. L., Stricks, L., Sackeim, H. A., et al (1987) Reliability and validity of measures of seizure duration. Convulsive Therapy, 3, 18–25.Google Scholar
Watkins-Pitchford, A. M. & Reynolds, F. (1984) Autonomic monitor for electroconvulsive therapy. British Journal of Psychiatry, 145, 551–552.Google Scholar
Weiner, R. D., Rogers, H. J., Welch, C. A., et al (1983) ECT stimulus parameters and electrode placement: relevance to therapeutic and adverse effects. In ECT: Basic Mechanism (eds Lerer, B., Weiner, R. & Belmaker, R.). London: John Libbey.Google Scholar
Zorumski, C. F., Birke, W. J., Rotherford, J. L., et al (1986) ECT: clinical variables, seizure duration and outcome. Convulsive Therapy, 2, 109–119.Google Scholar
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