From the *Department of Psychiatry, Washington University School of Medicine, St. Louis, MO and †BJC Behavioral Health, St. Louis, MO.
J ECT. 2014 Mar;30(1):69-72. doi: 10.1097/YCT.0b013e31829a01d3.
Catatonia is a neuropsychiatric syndrome involving motor signs in association with disorders of mood, behavior, or thought. Bitemporal electrode placement electroconvulsive therapy (ECT) is a proven effective treatment for catatonia, and this mode of ECT delivery is the preferred method of treatment in this condition. Studies in major depressive disorder have demonstrated that suprathreshold, nondominant (right) hemisphere, unilateral electrode placement ECT has fewer adverse effects, especially cognitive adverse effects, than bitemporal ECT. This case series describes the use of right unilateral (RUL) ECT in 5 patients with catatonia. Before ECT, all 5 patients in this series initially failed therapy with benzodiazepines and psychotropic medications. Each catatonic patient received a series of 8 to 12 RUL ECT in an every-other-day series. After ECT, 4 of the 5 patients had a full recovery from catatonia. One patient achieved only partial response to RUL ECT, and no additional benefit was obtained with bitemporal ECT. All patients in this case series tolerated RUL ECT without major adverse effects. This case series illustrates successful use of RUL ECT in patients with catatonia and adds to the early literature demonstrating its effective use in treating this complex condition.
紧张症是一种涉及运动体征的神经精神综合征，与情绪、行为或思维障碍有关。双颞部电极位置电惊厥疗法（ECT）是一种已被证实的有效的紧张症治疗方法，这种 ECT 输送方式是该病症的首选治疗方法。在重度抑郁症的研究中已经证明，阈上、非优势（右侧）半球、单侧电极位置 ECT 的不良反应，特别是认知不良反应，比双颞部 ECT 更少。本病例系列描述了 5 例紧张症患者使用右侧单侧（RUL）ECT 的情况。在 ECT 之前，本系列中的所有 5 例患者最初都未能通过苯二氮䓬类药物和精神药物治疗。每位紧张症患者均接受了 8 至 12 次 RUL ECT 的隔日系列治疗。ECT 后，5 例患者中有 4 例从紧张症中完全康复。1 例患者仅对 RUL ECT 有部分反应，双侧 ECT 没有额外获益。本病例系列中的所有患者均耐受 RUL ECT，无重大不良反应。本病例系列说明了 RUL ECT 在紧张症患者中的成功应用，并补充了早期文献中证明其在治疗这种复杂疾病方面的有效应用。
