K.GIRISH , M.D., D.N.B., Senior Resident, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore- 560029.
Indian J Psychiatry. 2002 Jan;44(1):24-8.
Eliciting cerebral seizure during electroconvulsive therapy (ECT) is essential for therapeutic purposes. When it exceeds beyond 120 seconds (Freeman, 1995) i.e., prolonged, it adds to adverse effects of ECT. Estimating seizure duration using 'cuff method' alone has limitations. This study examined the merits of electroencephalographic (EEG) monitoring in routine ECT practice on a large representative sample. Modified ECT either unilateral or bilateral electrode placement, was administered to 485 patients under EEG monitoring at first ECT session. Ninety one (18.8%) patients had prolonged seizures of which only 59 would have been detected if 'cuff method' alone was used. Twenty nine (6%) patients had inadequate motor seizures but had adequate EEG seizure duration. Twenty five (5.2%) of them had no motor seizure and two such patients even had prolonged seizures. The prolonged seizure was unpredictable in majority. In conclusion, EEG monitoring during ECT is essential to detect both adequacy of cerebral seizure in patients having no or inadequate motor seizures and a/so to detect prolonged seizures.
在电抽搐治疗 (ECT) 中引发脑抽搐对于治疗目的至关重要。当抽搐持续时间超过 120 秒（Freeman，1995），即延长时，它会增加 ECT 的不良反应。仅使用“袖带法”估计抽搐持续时间存在局限性。本研究在一个大的代表性样本中检查了在常规 ECT 实践中使用脑电图 (EEG) 监测的优点。在首次 ECT 治疗中，对 485 名患者进行了改良 ECT（单侧或双侧电极放置），并在 EEG 监测下进行。91 名（18.8%）患者出现抽搐持续时间延长，其中如果仅使用“袖带法”，则仅能检测到 59 名患者。29 名（6%）患者的运动性抽搐不足，但 EEG 抽搐持续时间足够。其中 25 名（5.2%）患者无运动性抽搐，两名患者甚至出现抽搐持续时间延长。大多数情况下，抽搐持续时间延长是不可预测的。总之，ECT 期间进行 EEG 监测对于检测无或运动性抽搐不足的患者的脑抽搐的充分性以及检测抽搐持续时间延长至关重要。
