Treatment of status epilepticus with electroconvulsive therapy.
OBJECTIVE
To describe a case in which electroconvulsive therapy (ECT) was used successfully to treat refractory status epilepticus (SE) after all pharmacological therapies were exhausted.


METHODS
A 39-year-old man with no seizure history presented in SE secondary to presumed viral encephalitis. His seizures remained refractory to medical management, and he was placed in a pentobarbital-induced coma. Multiple attempts to wean pentobarbital over the next several months failed due to SE relapses. With all standard pharmacological therapies exhausted, the patient underwent a series of 3 ECT sessions per day for 3 consecutive days. Electroencephalogram improvements were noted immediately with diffusely slow activity and with a delayed response over time in the patient's neurological examination. Twelve months post-ECT, the patient is awake, alert, and being managed on antiepileptic medications as outpatient.


CONCLUSIONS
This case further illustrates the role of ECT in the treatment of refractory SE.
Cline
J Scott
JS
School of Medicine, Department of Neurology, Indiana University, Indianapolis, IN 46234, USA. jcline@iupui.edu
Roos
Karen
K
D000328:Adult; D004565:Electroconvulsive Therapy / Q000379:methods*; D004569:Electroencephalography; D006801:Humans; D008297:Male; D013226:Status Epilepticus / Q000503:physiopathology / Q000628:therapy*