Chanpattana W, Chakrabhand S, Techakasem P, Raksakietisak S
Department of Psychiatry, Srinakharinwirot University, Bangkok, Thailand.
J Med Assoc Thai. 2000 Mar;83(3):278-83.
Seizure threshold determination is of crucial importance in optimizing electrical stimulus dosage at electroconvulsive therapy (ECT). We measured initial seizure threshold by means of Srinakharinwirot University titration schedule in 106 patients with schizophrenia or schizoaffective disorder, receiving bilateral ECT. Seizure threshold was approximately 106 millicoulombs on average, and varied 5-fold across patients. Seizure threshold was directly related to age, but inversely related to motor seizure duration. Comparisons of stimulus charge were done with the Age and Half age methods. By using the Half age method, 68 per cent of patients would have seized at the first stimulation and resulted in a closer mean charge to dose-titration method than the Age method. The results may have important clinical implications for stimulus dosing strategy in ECT.
在优化电休克治疗（ECT）的电刺激剂量时，癫痫发作阈值的测定至关重要。我们采用诗纳卡宁威洛大学滴定方案，对106例接受双侧ECT治疗的精神分裂症或分裂情感性障碍患者测定了初始癫痫发作阈值。癫痫发作阈值平均约为106毫库仑，不同患者之间相差5倍。癫痫发作阈值与年龄直接相关，但与运动性癫痫发作持续时间呈负相关。采用年龄法和半年龄法对刺激电量进行了比较。使用半年龄法时，68%的患者在首次刺激时就会发作，且与剂量滴定法相比，其平均电量比年龄法更接近剂量滴定法。这些结果可能对ECT的刺激给药策略具有重要的临床意义。
