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电抽搐治疗后伴有紧张型精神分裂症患者出现一过性发热反应:病例报告。

Transient Fever Response After ECT in a Patient with Catatonic Schizophrenia: A Case Report.

出版信息

Turk Psikiyatri Derg. 2024 Spring;35(1):78-82. doi: 10.5080/u26972.

Abstract

Electroconvulsive therapy (ECT) is an effective and safe treatment method for many psychiatric disorders. In general medical practice, ECT may cause side effects as most other treatment methods do. Headache, myalgia, nausea, vomiting, confusion, anterograde amnesia are common side effects of electroconvulsive therapy. Fever; in addition to general medical conditions such as infection, malignancy, connective tissue diseases, drug treatments, malignant hyperthermia, convulsions, it can also occur due to conditions such as neuroleptic malignant syndrome (NMS), serotonin syndrome, catatonia, malignant catatonia, which are frequently encountered in psychiatry clinics. In the literature, transient fever response due to electroconvulsive therapy application have been described, albeit rarely. Although there are many proposed mechanisms for the emergence of a fever response, regardless of its cause, it is still not understood why some fever responses occur. In this article, we present the differential diagnosis of the fever response, possible causes, and the mechanisms that may reveal the secondary fever response to electroconvulsive therapy in a case with a diagnosis of catatonic schizophrenia, who developed a fever response during electroconvulsive therapy sessions and no fever response was observed at times other than electroconvulsive therapy sessions. In this case, postictal benign fever response associated with electroconvulsive therapy was considered after excluding other medical conditions that may cause a fever response after electroconvulsive therapy. Keywords: ECT, Fever, Catatonia, NMS.

摘要

电抽搐治疗(ECT)是许多精神疾病的有效且安全的治疗方法。在一般的医疗实践中,ECT 可能会像大多数其他治疗方法一样引起副作用。头痛、肌肉痛、恶心、呕吐、意识混乱、顺行性遗忘是电抽搐治疗的常见副作用。发热;除了感染、恶性肿瘤、结缔组织疾病、药物治疗等一般医疗情况外,恶性高热、抽搐等情况也会导致发热,还可能由于神经阻滞剂恶性综合征(NMS)、血清素综合征、紧张症、恶性紧张症等情况导致发热,这些情况在精神科诊所中经常遇到。文献中描述了由于电抽搐治疗应用而导致的短暂发热反应,尽管很少见。尽管有许多关于发热反应出现的机制的建议,但无论其原因如何,仍不清楚为什么会发生一些发热反应。在本文中,我们介绍了发热反应的鉴别诊断、可能的原因以及机制,该机制可能揭示了诊断为紧张型精神分裂症的患者在电抽搐治疗期间出现发热反应,而在电抽搐治疗之外的其他时间则没有发热反应的情况下,电抽搐治疗后出现的继发性发热反应。在这种情况下,排除电抽搐治疗后可能引起发热反应的其他医疗状况后,考虑与电抽搐治疗相关的癫痫后良性发热反应。关键词:ECT、发热、紧张症、NMS。

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1
Fever as a Side Effect after Electroconvulsive Therapy.电抽搐治疗后的副作用之一:发热。
Neuropsychobiology. 2022;81(1):19-27. doi: 10.1159/000511542. Epub 2021 Jul 7.
2
When to consider electroconvulsive therapy (ECT).何时考虑电抽搐治疗(ECT)。
Acta Psychiatr Scand. 2020 Apr;141(4):304-315. doi: 10.1111/acps.13134. Epub 2019 Dec 23.
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Adverse Effects of Electroconvulsive Therapy.电休克治疗的不良反应
Psychiatr Clin North Am. 2016 Sep;39(3):513-30. doi: 10.1016/j.psc.2016.04.004. Epub 2016 Jun 25.
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Drug fever caused by propofol in the intensive care unit.重症监护病房中丙泊酚引起的药物热。
J Anesth. 2015 Oct;29(5):786-9. doi: 10.1007/s00540-015-2007-y. Epub 2015 Mar 24.
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Post-ECT hyperthermia and rapid mood improvements: a case report.
J Neuropsychiatry Clin Neurosci. 2014 Apr 1;26(2):E21. doi: 10.1176/appi.neuropsych.13020042.

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