title: A case of atypical tardive seizure activity during an initial ECT titration series.
abstract: Electroconvulsive therapy (ECT) has been used in this country for more than 70 years, is still the most effective treatment in all of psychiatry, and is considered a very safe procedure to have under general anesthesia. Although most patients tolerate this procedure very well without complications, prolonged and/or tardive seizures or even status epilepticus can develop, which is a rare but serious complication of ECT. Tardive seizures are typically associated with electroencephalographic evidence of ictal activity and motor manifestations of the tonic-clonic activity. Whereas there are instances of nonconvulsive status epilepticus after ECT, this is the first report of a patient developing autonomic and motor manifestations of a tardive seizure without electroencephalographic evidence of seizure activity during the initial titration series to establish seizure threshold for a course of ECT.
authors.affiliation: From the Departments of *Psychiatry, †Anesthesiology and ‡ Neurology, University of Iowa, Carver College of Medicine, Iowa City, IA.
authors.forename: Paul
authors.initials: P
authors.lastname: Thisayakorn
authors.forename: Yasser
authors.initials: Y
authors.lastname: Karim
authors.forename: Thoru
authors.initials: T
authors.lastname: Yamada
authors.forename: Laurie M
authors.initials: LM
authors.lastname: McCormick
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D004569:Electroencephalography; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use; D008991:Monitoring, Physiologic; D012640:Seizures / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D059020:Suicidal Ideation; D014057:Tomography, X-Ray Computed
chemical_list: D000927:Anticonvulsants; D008140:Lorazepam