Temporal lobe epilepsy following maintenance electroconvulsive therapy-Electrical kindling in the human brain?
Maintenance electroconvulsive therapy (ECT) is sometimes prescribed for refractory psychiatric conditions. We describe five patients who received maintenance ECT and developed florid temporal epileptiform abnormalities on electroencephalography (EEG) despite no history of epilepsy and normal neuroimaging. All patients had received regular ECT for at least 8 months. Three patients had clinical events consistent with epileptic seizures, and video-EEG monitoring captured electrographic seizures in two patients. After cessation of ECT the EEGs normalized in all patients, and no further clinical seizures occurred. Maintenance ECT may predispose to epilepsy with a seizure focus in the temporal lobe.
Department of Neurology, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
Alexander
A
Bryson
Department of Neurology, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
Helen
H
Gardner
Department of Neurology, Cairns Hospital, Cairns, Queensland, Australia.
Ian
I
Wilson
Department of Psychiatry, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
Tim
T
Rolfe
Department of Neurology, Austin Health, Heidelberg, Melbourne, Victoria, Australia.|Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.
John
J
Archer
D000328:Adult; D000369:Aged, 80 and over; D001921:Brain / Q000503:physiopathology*; D004565:Electroconvulsive Therapy / Q000379:methods*; D004569:Electroencephalography; D004827:Epilepsy / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007696:Kindling, Neurologic / Q000502:physiology; D008297:Male; D008875:Middle Aged
Electroconvulsive therapy; Epilepsy; Kindling