Department of Psychiatry, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.
J ECT. 2010 Dec;26(4):330-1. doi: 10.1097/YCT.0b013e3181cadc1f.
Little is known about the safety of electroconvulsive therapy (ECT) in patients with brain tumors, especially in patients with acoustic neuroma, which is difficult to diagnose early. For patients with somatoform disorder, physicians may alter the sensitivity to the somatic complaints, making it even more difficult to make an early diagnosis of "silent" brain tumors. This report describes a rare case involving treatment of refractory major depression and somatoform disorder that developed into increased intracranial pressure after ECT, possibly due to an undiagnosed acoustic neuroma. It is suggested that for patients with refractory major depression with somatoform disorders, the threshold of suspicion for silent tumors should be lowered and pre-ECT brain imaging study should be performed, specifically when the pattern of symptoms of the central nervous system-related somatoform syndrome changes.
关于脑肿瘤患者接受电抽搐治疗（ECT）的安全性知之甚少，尤其是对于早期诊断困难的听神经瘤患者。对于躯体形式障碍患者，医生可能会改变对躯体主诉的敏感性，从而更难以对“无声”脑瘤做出早期诊断。本报告描述了一例罕见病例，患者因难治性重度抑郁症和躯体形式障碍接受 ECT 治疗后发展为颅内压增高，可能与未诊断的听神经瘤有关。建议对于难治性重度抑郁症合并躯体形式障碍患者，应降低对无声肿瘤的怀疑阈值，并在 ECT 前进行脑部影像学检查，特别是当与中枢神经系统相关的躯体形式综合征的症状模式发生变化时。
