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Treatment of Status Epilepticus With Electroconvulsive Therapy

Cline, J. Scott MS4*; Roos, Karen MD

doi: 10.1097/01.yct.0000263260.36915.2a
Case Reports

Objective: To describe a case in which electroconvulsive therapy (ECT) was used successfully to treat refractory status epilepticus (SE) after all pharmacological therapies were exhausted.

Methods: A 39-year-old man with no seizure history presented in SE secondary to presumed viral encephalitis. His seizures remained refractory to medical management, and he was placed in a pentobarbital-induced coma. Multiple attempts to wean pentobarbital over the next several months failed due to SE relapses. With all standard pharmacological therapies exhausted, the patient underwent a series of 3 ECT sessions per day for 3 consecutive days. Electroencephalogram improvements were noted immediately with diffusely slow activity and with a delayed response over time in the patient's neurological examination. Twelve months post-ECT, the patient is awake, alert, and being managed on antiepileptic medications as outpatient.

Discussion: This case further illustrates the role of ECT in the treatment of refractory SE.

From the *School of Medicine and †Department of Neurology, Indiana University, Indianapolis, IN.

Received for publication September 30, 2006; accepted November 10, 2006.

Reprints: Jonathon Scott Cline, MS4 Indiana University, 5596 James Blair Drive, Indianapolis, IN 46234 (e-mail: jcline@iupui.edu).

© 2007 Lippincott Williams & Wilkins, Inc.