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首页> 外文期刊>The journal of ECT >Maintenance ECT as a therapeutic approach to medication-refractory epilepsy in an adult with mental retardation: Case report and review of literature
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Maintenance ECT as a therapeutic approach to medication-refractory epilepsy in an adult with mental retardation: Case report and review of literature

机译：维持ECT作为成人智力低下药物难治性癫痫的治疗方法：病例报告和文献复习

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BACKGROUND: Electroconvulsive therapy (ECT) raises the seizure threshold. This physiological change may benefit patients with seizure disorders. Whereas ECT has recently been used to terminate medication-refractory status epilepticus, there is little current literature on its planned administration as a specific maintenance treatment for medication-refractory epilepsy. METHODS: We used maintenance ECT to treat an 18-year-old man with a long-standing generalized tonic-clonic seizure disorder who had shown poor response to several antiepileptic drugs administered in combination with antiepileptic medication compliance confirmed through drug level monitoring. RESULTS: A total of 52 ECTs were administered across nearly 20 months at a mean frequency of once in nearly 12 days. From the very outset, ECT dramatically decreased the frequency of spontaneous seizures from approximately 6 to 24 per week at baseline to approximately 1 to 2 per week after ECT initiation. The efficacy of maintenance ECT in spontaneous seizure prophylaxis was greater when the ECT treatment interval was narrower. Improvement with ECT was associated with improved behavior and improved psychosocial functioning on clinical report. No cognitive or other adverse effects were reported or clinically ascertained. The ECT charge administered at the last 10 treatment sessions was 1434 millicoulombs. This is probably the highest electrical stimulus dose recorded in literature. CONCLUSIONS: Maintenance ECT may reduce the frequency of breakthrough seizures in patients with seizure disorder that is inadequately responsive to antiepileptic medication regimes. Very high ECT seizure thresholds may be observed when many antiepileptic drugs are concurrently administered in high doses.
机译：背景：电惊厥疗法（ECT）提高了癫痫发作的阈值。这种生理变化可能会使癫痫发作患者受益。鉴于ECT最近已被用于终止药物难治性癫痫病的治疗，但目前尚无计划将其作为药物难治性癫痫的特殊维持治疗的文献。方法：我们使用维持性ECT治疗一名18岁的长期患有广泛性强直-阵挛性癫痫病的人，该人对几种抗癫痫药联合通过药物水平监测证实的抗癫痫药依从性显示不良反应。结果：在近20个月内共进行了52次ECT治疗，平均频率为近12天一次。从一开始，ECT就将自发性癫痫发作的频率从基线时的每周大约6到24次降低到ECT启动后的每周大约1到2次。当ECT治疗间隔较窄时，维持ECT在自发性癫痫发作预防中的功效更大。临床报告显示，ECT的改善与行为改善和社会心理功能改善有关。没有认知或其他不良反应的报道或临床确定。在最后10个疗程中给予的ECT电荷为1434毫欧。这可能是文献中记录的最高电刺激剂量。结论：维持ECT可以减少对抗癫痫药物治疗反应不足的癫痫发作患者突破性癫痫发作的频率。当许多抗癫痫药以高剂量同时给药时，可能会观察到非常高的ECT癫痫发作阈值。

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