Folkerts H
Department of Psychiatry, University of Münster, Germany.
Eur Arch Psychiatry Clin Neurosci. 1996;246(3):155-64. doi: 10.1007/BF02189117.
The question of how to define a therapeutically adequate electroconvulsive therapy (ECT) has been under discussion since the early days of ECT. Although convention has asserted a demand for minimum seizure times, the complex electrophysiological conditions involved in developing a generalized seizure make it problematic for therapeutic efficacy of ECT to be linked only with seizure duration. Within the framework of an open clinical study of 40 patients, selected parameters of the ictal electroencephalogram (EEG) have now been examined with respect to differentiation between therapeutically effective and ineffective treatments. For this purpose a rating scale covering both quantitative and qualitative features of the ictal EEG was used. Although this study recorded no correlations between seizure duration and clinical improvement, correlations were established between clinical improvement, on the one hand, and the frequency of epileptic discharges and their slowing during the spike-wave phase as well as the stereotypy of the discharge or a "stable" pattern of rhythmic spike-wave or sharp wave complexes, on the other. The results suggest that several of these EEG parameters might be combined to form a marker for therapeutically adequate ECT, and that treatment might be controlled accordingly.
自电休克治疗（ECT）早期以来，如何定义具有治疗效果的ECT一直是讨论的话题。尽管传统观念一直要求有最短的发作时间，但全身性发作产生过程中涉及的复杂电生理状况使得ECT的治疗效果仅与发作持续时间相关这一观点存在问题。在一项针对40名患者的开放性临床研究框架内，现在已经对发作期脑电图（EEG）的选定参数进行了研究，以区分治疗有效的和无效的治疗。为此，使用了一个涵盖发作期EEG定量和定性特征的评分量表。尽管该研究未发现发作持续时间与临床改善之间存在相关性，但一方面发现临床改善与癫痫放电频率及其在棘波期的减慢以及放电的刻板性或节律性棘波或锐波复合波的“稳定”模式之间存在相关性。结果表明，这些EEG参数中的几个可能会被组合起来，形成一个具有治疗效果的ECT的标志物，并且治疗可以据此进行控制。
