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首页> 外文期刊>The journal of ECT >Exceptionally high initial seizure threshold in a patient treated with electroconvulsive therapy: A case report
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Exceptionally high initial seizure threshold in a patient treated with electroconvulsive therapy: A case report

机译：电惊厥治疗患者的初始癫痫发作阈值异常高：一例病例报告

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OBJECTIVES: Seizure threshold in electroconvulsive therapy (ECT) is defined as the smallest dose of electrical stimulus that produces a generalized seizure of at least 25 to 30 seconds as recorded by electroencephalography. Seizure thresholds vary considerably, with some patients demonstrating an exceptionally high initial seizure threshold. This case report describes a patient with schizoaffective disorder and an initial seizure threshold exceeding 1100 millicoulombs (mC), higher than can be delivered by the ECT device used. METHODS: A review of the literature was carried out to identify other reports of the phenomena. RESULTS: Six articles reporting on 9 patients with mental illness and exceptionally high initial seizure thresholds were identified. These reports were of mainly elderly patients treated for severe depression. The initial seizure thresholds ranged from 335 to 896 mC. In 6 of the 9 cases, ECT was given bilaterally; and in these cases, the median initial seizure threshold was 624 mC (interquartile range, 274 mC). CONCLUSIONS: Patients with exceptionally high initial seizure thresholds are rare, and few have been reported in the literature. The initial seizure threshold described in this case report is well in excess of others previously reported. The report highlights the potential for raised seizure thresholds in those taking mood-stabilizing antiepileptic medication.
机译：目的：电惊厥治疗（ECT）的癫痫发作阈值定义为产生最小癫痫发作剂量的最小电刺激，如通过脑电图记录的那样，至少可引起25到30秒的全身性癫痫发作。癫痫发作阈值相差很大，有些患者表现出异常高的初始癫痫发作阈值。该病例报告描述了一名患有精神分裂症的患者，其初始癫痫发作阈值超过1100毫居仑（mC），高于所使用的ECT装置所能提供的阈值。方法：对文献进行了审查，以确定其他现象的报告。结果：六篇文章报道了9例精神疾病患者，并且初始癫痫发作阈值异常高。这些报告主要针对严重抑郁症的老年患者。最初的癫痫发作阈值为335至896 mC。 9例中有6例是双侧给予ECT。在这些情况下，初始癫痫发作阈值中位数为624 mC（四分位间距为274 mC）。结论：初始癫痫发作阈值异常高的患者很少，文献报道很少。本病例报告中描述的初始癫痫发作阈值远远超过了先前报告的其他阈值。该报告强调了服用稳定情绪的抗癫痫药的癫痫发作阈值升高的可能性。

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