Abstract
During electroconvulsive therapy (ECT), occurrence of seizure must be confirmed. Cuff method, although simple and reliable, can sometimes miss an adequate EEG seizure. Predictable cardiovascular response occurs during ECT seizure. We examined if this can be an additional guide to detect cerebral seizure. In 164 modified ECT sessions, EEG and cuff methods were used for seizure monitoring. Heart rate (HR in beats per minute) and blood pressure (BP in mm of Hg) were recorded before (baseline) and 20 seconds after the stimulus (ictal). The rate pressure product (RPP=HR x systolic BP) was computed. The ECT sessions consisted of three groups, viz., adequate EEG and motor seizure (n=126), adequate EEG but not motor seizure (n=21) and neither EEG nor motor seizure adequate (n=17). Significant elevation of RPP occurred from baseline to ′ictal′ recording and this was different between the three groups. Ictal RPP did not differ between groups with or without adequate motor seizure if EEG seizure was adequate. The group with no adequate EEG or motor seizure had the least ′ictal′ RPP. Findings suggest that RPP response can be an additional clinical measure to detect seizures during ECT.
Keywords: Cardiovascular response, electroconvulsive therapy, seizure, cuff method
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- ADDERLEY D. J., HAMILTON M. Use of succinylcholine in E.C.T., with particular reference to its effect on blood pressure. Br Med J. 1953 Jan 24;1(4803):195–197. doi: 10.1136/bmj.1.4803.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fink M., Johnson L. Monitoring the duration of electroconvulsive therapy seizures: 'cuff' and EEG methods compared. Arch Gen Psychiatry. 1982 Oct;39(10):1189–1191. doi: 10.1001/archpsyc.1982.04290100055009. [DOI] [PubMed] [Google Scholar]
- Gangadhar B. N., Mayur P. M., Janakiramaiah N., Subbakrishna D. K., Rao G. S. Cardiovascular response during ECT: a cross-over study across stimulus conditions. J ECT. 2000 Jun;16(2):177–182. doi: 10.1097/00124509-200006000-00009. [DOI] [PubMed] [Google Scholar]
- Mayur P. M., Gangadhar B. N., Janakiramaiah N., Subbakrishna D. K. Motor seizure monitoring during electroconvulsive therapy. Br J Psychiatry. 1999 Mar;174:270–272. doi: 10.1192/bjp.174.3.270. [DOI] [PubMed] [Google Scholar]
- Murali N., Saravanan E. S., Santosh M. G., Gangadhar B. N., Janakiramaiah N., Rao G. S., Kumar S. S., Subbakrishna D. K., Christopher R. Cardiovascular response to ect is unaffected by extent of motor seizure modification. Indian J Psychiatry. 1999 Jul;41(3):236–241. [PMC free article] [PubMed] [Google Scholar]
- Scott A. I., Shering P. A., Dykes S. Would monitoring by electroencephalogram improve the practice of electroconvulsive therapy? Br J Psychiatry. 1989 Jun;154:853–857. doi: 10.1192/bjp.154.6.853. [DOI] [PubMed] [Google Scholar]
- Welch Charles A., Drop Lambertus J. Cardiovascular Effects of ECT. Convuls Ther. 1989;5(1):35–43. [PubMed] [Google Scholar]