Drake M E, Shy K E
Ohio State University College of Medicine, Columbus 43210.
Clin Electroencephalogr. 1989 Jan;20(1):55-7. doi: 10.1177/155005948902000112.
The EEG has been a widely-used screening procedure before ECT. Previous studies have correlated seizures and post-ECT slowing with ECT efficacy. We investigated the utility of pre-ECT EEG in predicting therapeutic response and post-ECT confusion. EEGs were normal in 54 of 100 patients undergoing first courses of ECT for refractory depression. Patterns within the normal range, were present in 26/100 while 2/100 had paroxysmal discharges without clinical evidence of epilepsy. Focal and generalized EEG slowing were each present in 9/100 records. Full recovery occurred after ECT in 66.6 per cent of those with normal pre-ECT records, 61.5 per cent with borderline EEGs, 55.5 per cent of patients with diffuse EEG slowing, and 22.2 of cases with focal slow waves. Of those with EEG slowing 22.2 percent had little or no response to ECT as compared to 19.2 per cent with EEGs within normal limits and 9.3 per cent with normal EEGs. Four of 6 patients with prolonged confusion had normal EEGs, while 1 each had focal and generalized slowing. EEG slowing was related to incomplete ECT response, but not to therapeutic failure or post-ECT confusion. The limited predictive power of pre-ECT EEG may reflect the prevalence of normal or nonspecifically abnormal EEGs in psychiatric patients and the general efficacy of ECT. Other neurophysiologic methods may yield more definitive information about the mechanism and use of ECT.
脑电图（EEG）一直是电休克治疗（ECT）前广泛使用的筛查程序。以往的研究已将癫痫发作及ECT后的慢波与ECT疗效相关联。我们研究了ECT前脑电图在预测治疗反应及ECT后意识模糊方面的作用。100例因难治性抑郁症接受首次ECT治疗的患者中，54例脑电图正常。100例中有26例脑电图处于正常范围模式，2例有阵发性放电但无癫痫临床证据。100份记录中，局灶性和广泛性脑电图减慢各有9例。ECT前记录正常的患者中，66.6%完全康复；脑电图临界的患者中，61.5%完全康复；脑电图弥漫性减慢的患者中，55.5%完全康复；有局灶性慢波的病例中，22.2%完全康复。脑电图减慢的患者中，22.2%对ECT几乎无反应或无反应，而脑电图正常范围的患者中这一比例为19.2%，脑电图正常的患者中为9.3%。6例意识模糊持续时间较长的患者中，4例脑电图正常，局灶性和广泛性减慢各有1例。脑电图减慢与ECT反应不完全相关，但与治疗失败或ECT后意识模糊无关。ECT前脑电图的预测能力有限，可能反映了精神病患者中脑电图正常或非特异性异常的普遍性以及ECT的总体疗效。其他神经生理学方法可能会提供有关ECT机制及应用的更确切信息。
