Epileptic status as a complication of electroconvulsive therapy: a case report

Abstract

Introduction. Electroconvulsive therapy (ECT) is a safe and effective treatment for multiple indications in psychiatric disorders. However, rare complications, such as cardiovascular compromise, post-stroke agitation and epileptic status, can occur. Case report. The case of an 83-year old female who had clinical symptoms consistent with psychotic depression, intense anguish, pronounced psychomotor retardation and who refused intake with secondary dehydration is presented. Treatment was started with ECT with great improvement of the symptoms, but in the third session of ECT, with the same intensity as the previous ones, electrical epileptic status with no clinical manifestations appeared. It lasted approximately 700 seconds. ECT was suspended and the patient was monitored electroencephalographically. Recovery since then has been progressive but much slower. Conclusion. It is essential to recognize and treat prolonged seizures during ECT to prevent progression to epileptic status. We recommend conducting a retrospective study aimed at identifying risk factors for the occurrence of nonconvulsive status epilepticus in potential patients and to protocolize preventive measures in order to avoid this complication.