ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A double-blind, randomized, comparative study of the therapeutic efficacy and side effects of unilateral electroconvulsive therapy (ECT) given with two different stimulus types was carried out in the Kuffner Sanatorium, Horni Berkovice, Czech Republic. Brief or ultrabrief pulse stimuli were used in 48 hospitalized patients, ages 17–61 years, diagnosed with either schizophrenia (n=42) or major depression (n=6). All patients received eight unilateral treatments each. Their clinical state and presence of cognitive impairment were evaluated with a battery of tests and rating scales before ECT, after the last ECT, and 1 month later. Patients were markedly improved after the course of ECT, and the improvement was maintained 1 month later. There were no significant differences in the extent of improvement between the groups treated with brief-and ultrabrief-pulse stimuli. No deleterious effects on cognitive functions and memory were detected. In fact, there was a trend toward improvement in memory and other cognitive functions after ECT in both groups, with no significant difference between them. The two stimulus waveforms studied (brief and ultrabrief pulse) thus appear to be equally effective and free of deleterious effects on memory and cognition. The response in schizophrenic patients was remarkable and deserving of further study.

ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

We report on the first direct comparison of measures of seizure quality generated by visual rating of electroencephalographic (EEG) regularity and postictal suppression with THYMATRON-DGx computer-generated indices of seizure energy and postictal suppression. Thirty-two consecutive patients referred for electroconvulsive therapy (166 consecutive treatments) were studied. Blinded ratings of seizure duration, regularity, and postictal EEG amplitude suppression derived from the paper EEG were compared against computer-rated measures of seizure duration, seizure energy index, mean ictal amplitude, and postictal suppression. Our results confirm previous findings of high correlations between computer and visual determinations of seizure duration. Significant differences were found for computer-derived postictal suppression, seizure energy index and mean ictal amplitude for different levels of the visual rating scales. Our results provide preliminary support for the concurrent validity of these measures.

ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Earlier research indicated the efficacy of a complex herbal formulation in the attenuation of electroconvulsive shock (ECS)-induced amnestic deficits in rats; this study sought to ascertain whether a simplified herbal formulation (Memorin; Phyto-Pharma, India) also was effective. Rats pretreated for a fortnight with Memorin (200 mg/kg/day) or vehicle were exposed to a passive-avoidance learning paradigm in a shuttle box. The next day, the rats were administered two true or sham ECSs, 5 h apart; recall of the pre-ECS learning was reassessed on the following day. ECS was found to produce significant retrograde amnesia (p< 0.002). Memorin attenuated the ECS-induced amnesia (p=0.00003) without influencing the ECS seizure duration. The clinical implications of these findings are discussed.

ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Many factors influence seizure duration associated with electroconvulsive therapy (ECT). This is a chart review study to assess seizure duration measured with both electroencephalography and electromyography after anesthetic induction with either thiopentone or etomidate. Thirty-seven patients receiving ECT for depression were entered into the study, and a pair of seizures was measured from each patient. Alternate induction agents were used in sequential pairings, and the study was controlled for interval between seizures, laterality, and percent energy. Etomidate was associated with a significantly (p=0.0002,F=15.84,df=1, analysis of variance) longer seizure duration (mean=34.43 s, SD=16.06) than thiopentone (mean=21.73 s, SD=9.33).

ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The effect of electrode placement on cardiovascular responses was studied. Rate pressure product and diastolic blood pressure before anesthesia and 30 s after electroconvulsive therapy (ECT) seizure were recorded. Recordings were made at the first (threshold ECT) session in 124 bilateral ECT (BLECT) and 95 unilateral ECT (ULECT) consenting patients. Postictal rate pressure product (RPP) was significantly higher after BLECT than ULECT. Mean increase in RPP from pre-to postictal phase was 31% in the former. The corresponding change with ULECT (20%) was significantly smaller. In the stepwise, multiple regression model, pre-ECT RPP, age, and stimulus laterality significantly contributed to postictal RPP. No cardiovascular complications occurred in any of the 219 ECT sessions.

ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Propofol is a nonbarbiturate anesthetic induction agent known to have anti-convulsant properties. When used as an anesthetic for electroconvulsive therapy (ECT), it can reduce seizure duration to a significant degree, which may not be fully appreciated. A case is presented in which propofol caused a 63.1% reduction in mean seizure duration compared with preceding and subsequent treatments with thiopental anesthesia. The literature on the use of propofol for ECT was reviewed with specific reference to its effect on seizure duration and any evidence of superiority to the barbiturate induction agents. It is concluded that propofol may have only very circumscribed indications as an anesthetic for ECT. If used, psychiatrists and anesthetists must be aware of its potency as an anticonvulsant.

ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A case is presented in which a patient with ischemic heart disease developed episodic, nonsustained ventricular tachycardia (VT) during electroconvulsive therapy for major depression. The VT had a frequency of 200 beats/min and ceased spontaneously after 17 s. Altered autonomic discharge in the presence of ischemia is the probable cause. Predisposing factors, as well as management considerations, are discussed.

ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Two elderly patients with severe depression were treated with electroconvulsive therapy despite long bone fractures. Good liaison was maintained throughout with the orthopaedic surgeons and anaesthetists. Both of the patients improved significantly, and there were no musculoskeletal complications.

ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1095-0680    

出版商:OVID    

年代:1998

数据来源: OVID