Suzuki Kazumasa, Shindo Tsuyoshi, Katsura Masahiro, Takamatsu Kousei, Ebina Yukio, Takano Takehisa, Awata Shuichi, Matsuoka Hiroo
Department of Psychiatry, Tohoku University Hospital, Tohoku University Graduate School of Medicine, Sendai, Japan.
J ECT. 2007 Jun;23(2):103-5. doi: 10.1097/yct.0b013e31803025f6.
Electroconvulsive therapy (ECT) has been shown to be effective in cases of medically intractable mood disorder and schizophrenia. However, some patients receiving ECT have only a short electroencephalographic seizure or no seizure at the maximum stimulus intensity and thus fail to obtain a therapeutic effect. A new treatment option is needed to induce therapeutic seizures in such patients. We report a case of catatonic schizophrenia that was resolved by successful seizure induction by means of ECT with electrodes applied bilaterally to the parietotemporal region after bifrontotemporal ECT failed to induce adequate seizure. We note that parietotemporal ECT can induce therapeutic seizures in patients with a high seizure threshold because more current penetrates the brain due to a decrease in shunted current.
电休克疗法（ECT）已被证明在治疗药物难治性情绪障碍和精神分裂症方面有效。然而，一些接受ECT治疗的患者在最大刺激强度下仅出现短暂的脑电图癫痫发作或无癫痫发作，因此未能获得治疗效果。需要一种新的治疗方法来诱导此类患者出现治疗性癫痫发作。我们报告一例紧张型精神分裂症患者，在双侧额颞叶ECT未能诱导出足够癫痫发作后，通过将电极双侧应用于顶颞区的ECT成功诱导癫痫发作，从而使病情得到缓解。我们注意到，顶颞区ECT可以在癫痫阈值较高的患者中诱导出治疗性癫痫发作，因为由于分流电流减少，更多电流能够穿透大脑。
