Reyes-Molón Laura, Trebbau-López Helena, Saiz-González Dolores
Instituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos, Madrid, Spain.
Actas Esp Psiquiatr. 2012 Mar-Apr;40(2):99-101. Epub 2012 Mar 1.
Electroconvulsive therapy (ECT) is a safe and effective treatment for multiple indications in psychiatric disorders. However, rare complications, such as cardiovascular compromise, post-stroke agitation and epileptic status, can occur.
The case of an 83-year old female who had clinical symptoms consistent with psychotic depression, intense anguish, pronounced psychomotor retardation and who refused intake with secondary dehydration is presented. Treatment was started with ECT with great improvement of the symptoms, but in the third session of ECT, with the same intensity as the previous ones, electrical epileptic status with no clinical manifestations appeared. It lasted approximately 700 seconds. ECT was suspended and the patient was monitored electroencephalographically. Recovery since then has been progressive but much slower.
It is essential to recognize and treat prolonged seizures during ECT to prevent progression to epileptic status. We recommend conducting a retrospective study aimed at identifying risk factors for the occurrence of nonconvulsive status epilepticus in potential patients and to protocolize preventive measures in order to avoid this complication.
电休克疗法（ECT）是治疗多种精神疾病的一种安全有效的方法。然而，可能会出现罕见的并发症，如心血管功能障碍、中风后躁动和癫痫持续状态。
介绍了一名83岁女性患者的病例，该患者有与精神病性抑郁症相符的临床症状、强烈痛苦、明显的精神运动迟缓，且拒绝进食导致继发性脱水。开始采用ECT治疗，症状有显著改善，但在第三次ECT治疗时，与前几次强度相同，出现了无临床表现的电癫痫持续状态。持续了约700秒。ECT治疗暂停，对患者进行脑电图监测。此后恢复过程是渐进的，但要慢得多。
在ECT治疗期间识别并治疗长时间癫痫发作以防止进展为癫痫持续状态至关重要。我们建议进行一项回顾性研究，旨在确定潜在患者中非惊厥性癫痫持续状态发生的危险因素，并制定预防措施方案以避免这种并发症。
