Limitations of motor seizure monitoring in ect

Jayaprakash, M S ; Gangadhar, B N ; Janakiramaiah, N ; Subbakrishna, D K Limitations of motor seizure monitoring in ect Indian Journal of Psychiatry, 40 (1). pp. 55-59. ISSN 0019-5545

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Seizures were monitored using both cuff method and EEG, during the first ECT session in 158 consecutive patients. All developed adequate EEG seizures (≥25 seconds). Twelve patients (8%) did not develop adequate motor seizures (15 seconds), of whom ten had no convulsive response. EEG seizure duration was less than 120 seconds in 117 patients (Group-A) and 120 or more seconds (prolonged) in the remaining 37 patients (Group-B). Adequate but not prolonged motor seizure (15-89 seconds) occurred in 111 patients in group A and 18 patients in group B. Motor seizure of 90 or more seconds (prolonged seizure) occurred in four patients in group A and 13 patients in group B. Based on the motor seizure criterion, 60% (18/31) of patients with prolonged EEG seizure were missed. The motor and EEG seizure durations correlated significantly in both groups. The correlation coefficient in group A was 0.78 (p< 0.01), which was significantly larger (Fisher's 'Z' transformation test, t=3.12, p< 0.01) than that in group B (0.37; p< 0.05). Out of the total 158 patients, motor seizure monitoring alone did not correctly classify 21.4% of ECT seizure. This could have resulted in either unnecessary re-stimulation or failure to detect prolonged seizure. The findings suggest that in ECT motor seizure monitoring alone is unsatisfactory and therefore the need for EEG seizure monitoring.

Item Type:Article
Source:Copyright of this article belongs to Indian Psychiatric Society.
Keywords:EEG Monitoring; Electroconvulsive Therapy; Prolonged Seizures..
ID Code:119423
Deposited On:13 Jun 2021 10:20
Last Modified:13 Jun 2021 10:20

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