RISK-FACTORS, CONSEQUENCES, AND TREATMENT OF ECT-INDUCED STATUS EPILEPTICUS

We report an instance of nonconvulsive status epilepticus after electr oconvulsive therapy (ECT) in a 76-year-old man. This case is notable f or an electroencephalogram (EEG)-monitored seizure of almost 1 h, abse nce of motor movements, resistance to a variety of anticonvulsants, an d the lack of commonly accepted risk factors for prolonged seizures. I n 757 EEG-monitored treatment episodes in a Veterans Administration me dical center, we found five instances in which seizure duration was pr olonged, but our case is the only instance of status epilepticus. If E CT-associated seizures of 180 s are by definition prolonged, but seizu res lasting 30 min represent status epilepticus, then prolonged seizur es are uncommon, but status epilepticus is rare. The risk factors for status epilepticus may differ From those for prolonged seizures and in clude frontal lobe disorders. We discuss the possible role of a recent frontal cortical infarct in the genesis of this episode. We further d iscuss the consequences of status epilepticus and the management there of.