Effectiveness of Electroconvulsive Therapy in Functional Neurological Disorders: A Case Report

Abstract

Electroconvulsive therapy is a type of therapy frequently used in psychiatric clinical practice. Although it is generally used for the treatment of affective disorders or severe and/or resistant psychotic disorders, it has also demonstrated its usefulness in many other neuropsychiatric conditions.   

We present the case of a 26-year-old woman, previously diagnosed with a functional neurological disorder—with fixed dystonia phenotype in the right upper limb—, admitted to our hospital for a severe depressive episode. After noting the absence of clinical improvement with psychopharmacological treatment, it was decided to give electroconvulsive therapy, receiving a total of 11 sessions, 9 of which were effective, with bifrontotemporal application, three times a week. The patient experienced a significant improvement, not only at an affective and behavioral level, but also in the dystonia, recovering most of the mobility in the right hand and completely relinquishing the pain.   

Although scientific evidence is scarce regarding the use of electroconvulsive therapy in functional neurological disorders, this clinical case supports the existing literature and raises this therapy as a possibility in resistant and comorbid conditions with severe affective disorders.