Lin Chia-Chi, Chiu Nien-Mu, Lee Yu, Wang Liang-Jen
Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang, Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial, Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Psychiatry Clin Psychopharmacol. 2024 Nov 28;34(4):349-352. doi: 10.5152/pcp.2024.24922.
Electroconvulsive therapy (ECT) has been employed as an effective treatment for refractory psychiatric disorders worldwide. Despite its extensive use, the occurrence of a fever following ECT has been rare and seldom documented. The reasons behind a post-ECT fever could vary; instances solely attributed to inflammation have been scarcely reported. We present the case of a 27-year-old woman diagnosed with bipolar disorder who experienced multiple fever episodes after having ECT. Diagnostic tests revealed elevated C-reactive protein (CRP) levels with no other infectious focus or possibility of neuroleptic malignant syndrome. We propose that this febrile reaction without real infection was related to inflammatory response triggered by ECT, with the release of various neurotransmitters into the brain and changes in the microsystems. Under this impression, we can speculate that it is a benign and reversible process, allowing us to continue ECT and achieve therapeutic efficacy. This might be the first report to suggest that an ECT-induced fever is related to inflammatory reactions.
在全球范围内，电休克疗法（ECT）已被用作治疗难治性精神疾病的有效方法。尽管其应用广泛，但ECT后出现发热的情况却很罕见，且鲜有文献记载。ECT后发热的原因可能多种多样；仅归因于炎症的情况几乎没有报道。我们报告了一例27岁被诊断为双相情感障碍的女性患者，她在接受ECT后出现了多次发热发作。诊断测试显示C反应蛋白（CRP）水平升高，没有其他感染病灶，也不存在抗精神病药物恶性综合征的可能性。我们认为这种无实际感染的发热反应与ECT引发的炎症反应有关，各种神经递质释放到大脑中以及微系统发生变化。基于这种认识，我们可以推测这是一个良性且可逆的过程，使我们能够继续进行ECT并实现治疗效果。这可能是第一份表明ECT诱发的发热与炎症反应有关的报告。
