Focal prefrontal seizures induced by bilateral ECT

It has been proposed that the greater efficacy of bilateral (BL) over right unilateral (RUL) electroconvulsive therapy (ECT) at low stimulus intensity is due to differences in site of seizure initiation. We hypothesized that focal prefrontal seizures are more common with BL than RUL administration....

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Bibliographic Details
Published inThe journal of ECT Vol. 17; no. 3; p. 175
Main Authors Boylan, L S, Devanand, D P, Lisanby, S H, Nobler, M S, Prudic, J, Sackeim, H A
Format Journal Article
LanguageEnglish
Published United States 01.09.2001
Subjects
Adult
Aged
Electroconvulsive Therapy
Electrodes
Female
Functional Laterality
Humans
Male
Middle Aged
Prefrontal Cortex - physiology
Retrospective Studies
Seizures - etiology
Seizures - physiopathology
Time Factors
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Summary:It has been proposed that the greater efficacy of bilateral (BL) over right unilateral (RUL) electroconvulsive therapy (ECT) at low stimulus intensity is due to differences in site of seizure initiation. We hypothesized that focal prefrontal seizures are more common with BL than RUL administration. Records were reviewed of the 1,007 ECT treatments of 84 consecutive patients randomized to RUL or BL electrode placement. Eight events were identified in which there was an electroencephalographic seizure without motor manifestation. All of these events occurred at titration sessions and with BL stimuli (p = 0.002). These events were more likely to occur later in the course of treatment. We suggest that BL ECT may induce focal seizures in prefrontal areas and that these seizures are more likely to occur later in the treatment course.
ISSN:1095-0680
DOI:10.1097/00124509-200109000-00005