ECT IN THE TREATMENT OF PATIENTS WITH NEUROLOGICAL AND SOMATIC DISEASE

Objective: An evaluation of the safety and efficacy of electroconvulsi ve therapy (ECT), for the treatment of patients with severe medical an d neurological illness, was undertaken. Method. The English-language l iterature reporting the use of ECT in patients with neurological and s omatic disease was reviewed. This review included reports describing E CT used for the treatment of affective disturbances and catatonia in p atients with concurrent neurological or somatic disease, as well as re ports dealing with the efficacy of ECT for the treatment of certain ne urological conditions for which it has been reported to have some bene fit independent of its psychiatric effect. Conclusions: ECT is safe an d effective for the treatment of affective and catatonic disorders in patients with most neurological and medical diseases, including elderl y and debilitated patients with multiple illnesses, if the specific me dical risks are carefully evaluated in each case, and appropriate modi fications of technique are used to reduce the risk of potential compli cations. Apart from its use in psychiatry, ECT has been reported to ha ve therapeutic effects in Parkinson's disease, neuroleptic malignant s yndrome, aggressive behavioral disorders following brain injury, certa in forms of epilepsy, and some forms of delirium due to toxic or metab olic encephalopathies. The potential for ECT to play an active role in the clinical management of patients with these disorders, many of who m are presently refractory to maximal medical treatment, should be eva luated by systematic studies.