Nel Yvette, Bracken Craig A
Department of Psychiatry, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.
S Afr J Psychiatr. 2023 Jan 30;29:1944. doi: 10.4102/sajpsychiatry.v29i0.1944. eCollection 2023.
The successful use of ECT as treatment for catatonia, in the context of HIV (human immunodeficiency virus) infection, has been described previously. Ketamine has been used as an anaesthetic induction agent for ECT, although not considered the induction agent of choice. There are also case reports suggesting that ketamine may be an alternative treatment specifically for catatonia.
This case report describes the management of a female patient who presented with catatonia, evidenced by stupor, waxy flexibility, mutism, negativism, and stereotypy, as well as stage four HIV infection, with poor response to previous psychotherapeutic interventions.
We describe the course of management of this patient with ECT, following poor initial clinical response to ECT with propofol induction, the subsequent use of ketamine as an anaesthetic induction agent for ECT, with associated improvement in seizure quality, and good overall clinical response to ECT demonstrated thereafter.
This case report suggests that ketamine may be a viable induction agent for ECT in this clinical setting.
此前已有关于在人类免疫缺陷病毒（HIV）感染背景下成功使用电休克疗法（ECT）治疗紧张症的描述。氯胺酮已被用作ECT的麻醉诱导剂，尽管它并非首选诱导剂。也有病例报告表明氯胺酮可能是专门用于治疗紧张症的替代疗法。
本病例报告描述了一名女性患者的治疗过程，该患者表现出紧张症，症状包括木僵、蜡样屈曲、缄默、违拗和刻板动作，同时患有IV期HIV感染，对先前的心理治疗干预反应不佳。
我们描述了该患者接受ECT治疗的过程，最初使用丙泊酚诱导进行ECT时临床反应不佳，随后使用氯胺酮作为ECT的麻醉诱导剂，癫痫发作质量有所改善，此后对ECT总体临床反应良好。
本病例报告表明，在这种临床情况下，氯胺酮可能是ECT的一种可行诱导剂。
