Strength Symmetry Index: A Measure of Seizure Adequacy in ECTGangadhar, B. N. M.D.; Janakiramaiah, N. M.D., Ph.D.; Dutt, Narayana D. Ph.D.; Motreja, S. M.D.The Journal of ECT: 1997 Stimulus Dosing in ECT: The Debate: PDF Only Abstract Summary: Seizure electroencephalography (EEG) was recorded from two channels—right (Rt) and left (Lt)—during bilateral electroconvulsive therapy (ECT) (n = 12) and unilateral ECT (n = 12). The EEG was also acquired into a microcomputer and was analyzed without knowledge of the clinical details. EEG recordings of both ECT procedures yielded seizures of comparable duration. The Strength Symmetry Index (SSI) was computed from the early- and midseizure phases using the fractal dimension of the EEG. The seizures of unilateral ECT were characterized by significantly smaller SSI in both phases. More unilateral than bilateral ECT seizures had a smaller than median SSI in both phases. The seizures also differed on other measures as reported in the literature. The findings indicate that SSI may be a potential measure of seizure adequacy that remains to be validated in future research. Received April 9, 1996; accepted November 22, 1996. Address correspondence and reprint requests to Dr. B. N. Gangadhar at Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560 029, India. © Lippincott-Raven Publishers.