A unilateral, prolonged, nonconvulsive seizure in a patient treated with bilateral ECT

We report on a case of a 45-year-old man in an episode of major depression with psychotic features treated with bilateral electroconvulsive therapy (E CT). At the eighth treatment, he manifested unilateral, prolonged, nonconvu lsive seizure activity on the left side, which lasted 351 seconds longer th an seizure activity on the right, and was terminated with intravenous diaze pam. This is the first report of a unilateral prolonged seizure. Its occurr ence following bilateral ECT was particularly noteworthy. This case also hi ghlights the importance of two-channel EEG recording during ECT. Without tw o recording channels we doubt that this event would have been detected, per haps resulting in nonconvulsive status epilepticus.