ELECTROCONVULSIVE-THERAPY FOR NEUROLOGICA L ILLNESS

Numerous developments have improved the safety and efficacy of electro convulsive therapy (ECT) in recent years, so that ECT is now one of th e safest forms of treatment under anesthesia. The indications for psyc hiatric patients are clearly defined. ECT is also under discussion wit h respect to certain neurological disorders. This discussion has, howe ver, been largely ignored by the German medical profession. Critical e valuation of previous experience, especially in the United States and in Scandinavia, reveals some clinical situations (e.g., akinetic crisi s in Parkinson's disease) in which a primary neurological indication f or ECT might be present. ECT is frequently indicated in other brain di seases if pronounced psychopathological disturbances (especially of a depressive type) occur and fail to respond to conventional treatment w ith psychotropic drugs. ECT may then be indicated on a case-by-case ba sis. ECT should not be withheld from such patients; on the other hand, there is the risk of uncontrolled expansion of these indica tions for ECT.