Saito Takahiro, Nakamura Mitsuru, Watari Michiko, Isse Kunihiro
Department of Psychiatry, Tokyo Metropolitan Toshima Hospital, Tokyo, Japan.
J ECT. 2008 Dec;24(4):275-6. doi: 10.1097/YCT.0b013e31816ba986.
Tardive seizure is a serious adverse reaction of electroconvulsive therapy (ECT). However, it was rarely reported in ECT sessions for psychiatric patients who needed concurrent antibiotic treatments. We present 2 cases of patients with schizophrenia who manifested a catatonic syndrome and were indicated for ECT, along with antibiotic therapies for infectious diseases with piperacillin and cefotiam, respectively. The beta-lactam antibiotics are reported to induce convulsions caused by the suppression of inhibitory GABAergic functions. In addition, there is a report on prolonged ECT seizure related to ciprofloxacin, which has an epileptogenic property with a similar action to beta-lactam antibiotics. Thus, tardive seizures in our cases are thought to be related to piperacillin and cefotiam.
迟发性癫痫发作是电休克治疗（ECT）的一种严重不良反应。然而，在需要同时进行抗生素治疗的精神病患者的ECT治疗过程中，这种情况很少被报道。我们报告2例精神分裂症患者，他们表现出紧张症综合征，并接受了ECT治疗，同时分别使用哌拉西林和头孢替安治疗传染病。据报道，β-内酰胺类抗生素可通过抑制抑制性γ-氨基丁酸能功能而诱发惊厥。此外，有一份关于与环丙沙星相关的延长ECT癫痫发作的报告，环丙沙星具有致癫痫特性，其作用与β-内酰胺类抗生素相似。因此，我们病例中的迟发性癫痫发作被认为与哌拉西林和头孢替安有关。
