RESUMEN
Creutzfeldt-Jakob disease is a degenerative disorder of the central nervous system that frequently presents with behavioral symptoms including depression. We report here a patient with Creutzfeldt-Jakob disease in whom electroconvulsive therapy (ECT) was highly effective in relieving depressive symptoms. Additionally, ECT had little or no effect on cognition in this patient, even transiently improving her cognitive function. Given its rapid onset of action, ECT may be considered safe and effective in depressive disorders associated with Creutzfeldt-Jakob disease.
RESUMEN
We performed a retrospective review of 5 years of experience with electroconvulsive therapy (ECT) in patients with organic brain lesions. On 26 of 27 occasions, patients with organic brain disease and a concurrent depressive disorder obtained a good affective response to a course of ECT. Patients with diffuse or multifocal brain disease were vulnerable to ECT-induced delirium; however, this was severe enough to compel discontinuation of ECT on only one occasion. We conclude that ECT is an effective treatment for depression in patients with concurrent neurological disease, although patients with degenerative brain disease or diffuse encephalopathy may be especially prone to ECT-induced delirium.
RESUMEN
Three cases of patients known to have cerebral meningiomas at the time of electroconvulsive therapy (ECT) are reported. They represent the seventh to ninth reported cases of patients with intracranial neoplasms treated prospectively with ECT. No patient suffered adverse effects referable to the presence of the tumors, and each obtained a good therapeutic response. The English language literature concerning the use of ECT in patients with intracranial neoplasms is reviewed, and it is concluded that ECT may be safely administered prospectively to patients with intracranial meningiomas after the risk of neurological complications has been evaluated with the appropriate diagnostic studies.
RESUMEN
The authors review the results of electroconvulsive therpay (ECT) in 135 cases of depression occurring in conjunction with organic dementia, subcortical leukoencephalopathy without dementia, and depressive dementia (22 cases). Overall, 86% had a positive therapeutic response to ECT, whereas 21% experienced significant cognitive or memory side effects, virtually all of which were transient and reversible. Forty-nine percent of the patients with organic or depressive dementias experienced improvement in cognitive or memory function consequent to ECT.
RESUMEN
Six patients who failed to respond to what would ordinarily be considered therapeutically effective courses of sequential unilateral nondominant (mean number 10) and bilateral brief-pulse electroconvulsive therapy (ECT) (mean number 10) with electroencephalographic (EEG) monitoring of seizure duration (all seizures >30 s) subsequently received courses of bilateral sinusoidal ECT (mean number 6) and responded well. Some theoretical implications and clinical considerations raised by these cases are discussed.
RESUMEN
In order to characterize the onset and evolution of early cognitive changes that accompany bilateral electroconvulsive therapy (ECT), the performance of 13 ECT-treated and 16 psychiatric control patients on a battery of neuropsychological tests administered daily was compared. These tests included: Digit Symbol, spokes, letter cancellation, and short-term memory tests. While both groups improved on all tests, performance of ECT patients vs. controls on letter cancellation tests diverged significantly (p < 0.005) after three ECTs. The authors speculate that this finding reflects an alteration in attentional processes caused by bilateral ECT.