Motor seizure monitoring during electroconvulsive therapy

1999 ◽  
Vol 174 (3) ◽  
pp. 270-272 ◽  
Author(s):  
Prashanth M. Mayur ◽  
B. N. Gangadhar ◽  
N. Janakiramaiah ◽  
D. K. Subbakrishna
Keyword(s):  
Electroconvulsive Therapy ◽  
Royal College ◽  
Eeg Monitoring ◽  
Rational Basis ◽  
Motor Seizure ◽  
Definition Of ◽  
Electroencephalogram Eeg

BackgroundThe occurrence of a seizure during electroconvulsive therapy (ECT) should be confirmed. Most clinicians use motor seizure monitoring alone and recent guidelines have not considered electroencephalogram (EEG) monitoring mandatory.AimsTo examine the potential pitfalls of motor seizure monitoring.MethodConsenting consecutive patients (n=232) were prospectively studied at the first ECT session using both motor and EEG seizure monitoring. It was ensured (by titration) that all the patients had an adequate EEG seizure. Adequate and prolonged seizures were defined according to the latest recommendations of the Royal College of Psychiatrists.ResultsMotor seizure was inadequate in 15 (7%) of patients. EEG seizure was prolonged in 38 (16%) of patients. Fifteen patients (39%) did not have a prolonged motor seizure. Motor seizure correlated well (r=0.8, P < 0.001) with EEG seizure when the latter was adequate, but not when prolonged (r=0.12, P > 0.5).ConclusionsMotor seizure monitoring without EEG is undependable. The study provides a rational basis for the Royal College of Psychiatrists' definition of prolonged EEG seizure.

scholarly journals Monitoring electroconvulsive therapy by electroencephalogram: an update for ECT practitioners

2007 ◽  
Vol 13 (4) ◽  
pp. 298-304 ◽  
Author(s):  
Allan I. F. Scott
Keyword(s):  
Electroconvulsive Therapy ◽  
Seizure Activity ◽  
Eeg Monitoring ◽  
The Real ◽  
End Point ◽  
The Status ◽  
Published Research ◽  
Electroencephalogram Eeg

The purpose of this article is to update practitioners on the latest published research into the prevalence of prolonged cerebral seizure activity following electroconvulsive therapy (ECT). This research is drawing attention to the real practical challenges of recording and reading an electroencephalogram (EEG) tracing in the ECT clinic. In particular, determination of the seizure end-point is not always practicable and this poses a major problem in the detection and management of prolonged cerebral seizure activity. Some practical tips are suggested, and an update is given on the status of EEG monitoring in the assessment of seizure adequacy.

scholarly journals Atypical Creutzfeldt-Jakob Disease Evolution after Electroconvulsive Therapy for Catatonic Depression

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Iria Grande ◽  
Juan Fortea ◽  
Ellen Gelpi ◽  
Itziar Flamarique ◽  
Marc Udina ◽  
...  
Keyword(s):  
Electroconvulsive Therapy ◽  
Disease Duration ◽  
Psychiatric Symptoms ◽  
Psychiatric Admission ◽  
Disease Evolution ◽  
Clinical Recovery ◽  
Jakob Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Electroencephalogram Eeg ◽  
Codon 129

We describe a case report of an 80-year-old woman who presented with symptomatology compatible with an episode of major depression with catatonia. After psychiatric admission, electroconvulsive therapy (ECT) was applied, but symptoms progressed with cognitive impairment, bradykinesia, widespread stiffness, postural tremor, and gait disturbance. After compatible magnetic resonance imaging (MRI), diffusion changes, and electroencephalogram (EEG) findings the case was reoriented to Creutzfeldt-Jakob disease (CJD). The genetic study found a methionine/valine heterozygosity at codon 129 of the prion protein gene PrPSc. On followup, a significant clinical recovery turned out. For this reason, EEG and MRI were repeated and confirmed the findings. The patient subsequently demonstrated progressive clinical deterioration and died 21 months later. The diagnosis was verified postmortem by neuropathology. The vCJD subtype MV2 is indeed characterized by early and prominent psychiatric symptoms and a prolonged disease duration however no frank clinical recovery has before been reported.

scholarly journals The Electroconvulsive Therapy Accreditation Service

2004 ◽  
Vol 28 (7) ◽  
pp. 257-259 ◽  
Author(s):  
Helen Caird ◽  
Adrian Worrall ◽  
Paul Lelliott
Keyword(s):  
Peer Review ◽  
Electroconvulsive Therapy ◽  
Royal College ◽  
College Of Nursing

The Electroconvulsive Therapy Accreditation Service (ECTAS) was launched in May 2003. Its purpose is to assure and improve the quality of the administration of electroconvulsive therapy. Participating clinics undergo a process of self- and peer-review. The Royal College of Psychiatrists' Court of Electors will award an accreditation rating to clinics that meet essential standards; this accreditation will last for 3 years, subject to annual self-review. Participating clinics will also receive feedback and advice about local strengths and areas for improvement. The accreditation service is endorsed by the Royal College of Nursing and the Royal College of Anaesthetists and has the support of the Healthcare Commission in relation to English services. Clinics that participate in ECTAS will be listed on the College website, with the accreditation rating awarded.

Is Electroencephalographic Monitoring of Electroconvulsive Therapy Clinically Useful?

1989 ◽  
Vol 154 (2) ◽  
pp. 229-231 ◽  
Author(s):  
R. G. McCreadie ◽  
K. Phillips ◽  
A. D. T. Robinson ◽  
G. Gilhooly ◽  
W. Crombie
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Clinical Efficacy ◽  
Electroconvulsive Therapy ◽  
National Health ◽  
Medical Staff ◽  
Eeg Monitoring ◽  
Future Work

Electroencephalographic (EEG) monitoring was carried out in 169 bilateral and 114 unilateral applications of electroconvulsive therapy (ECT), given to 51 patients in an everyday setting within the National Health Service by junior medical staff. In 2.5% of bilateral and 8% of unilateral applications there was disagreement between clinical and EEG assessment as to whether a fit had occurred. When an EEG fit was said to have occurred only if it lasted longer than 25 seconds, then disagreement rose to 7% in bilateral and 28% in unilateral applications; disagreement was higher with unilateral applications, as they produced more short fits than bilateral applications. If future work shows duration of seizure is clearly associated with clinical efficacy, it is suggested the case for routine EEG monitoring is greatly strengthened.

scholarly journals Calculating the proportion of avoidable attendances at UK emergency departments: analysis of the Royal College of Emergency Medicine’s Sentinel Site Survey data

2017 ◽  
Vol 35 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Toby Morris ◽  
Suzanne M Mason ◽  
Chris Moulton ◽  
Colin O’Keeffe
Keyword(s):  
Royal College ◽  
Emergency Care ◽  
Healthcare Setting ◽  
Sentinel Site ◽  
Site Survey ◽  
Younger Age ◽  
Universal Definition ◽  
Definition Of ◽  
The Uk ◽  
Ed Crowding

IntroductionAvoidable attendances (AAs; defined as non-urgent, self-referred patients who could be managed more effectively and efficiently by other services) have been identified as a contributor to ED crowding. Internationally, AAs have been estimated to constitute 10%–90% of ED attendances, with the UK 2013 Urgent and Emergency Care Review suggesting a figure of 40%.MethodsThis pilot study used data from the Royal College of Emergency Medicine’s Sentinel Site Survey to estimate the proportion of AAs in 12 EDs across England on a standard day (20 March 2014). AAs were defined by an expert panel using questions from the survey. All patients attending the EDs were recorded with details of investigations and treatments received, and the proportion of patients meeting criteria for AA was calculated.ResultsVisits for 3044 patients were included. Based on these criteria, a mean of 19.4% (95% CI 18.0% to 20.8%) of attendances could be deemed avoidable. The lowest proportion of AAs reported was 10.7%, while the highest was 44.3%. Younger age was a significant predictor of AA with mean age of 38.6 years for all patients attending compared with 24.6 years for patients attending avoidably (p≤0.001).DiscussionThe proportion of AAs in this study was lower than many estimates in the literature, including that reported by the 2013 Urgent and Emergency Care Review. This suggests the ED is the most appropriate healthcare setting for many patients due to comprehensive investigations, treatments and capability for urgent referrals.The proportion of AAs is dependent on the defining criteria used, highlighting the need for a standardised, universal definition of an appropriate/avoidable ED attendance. This is essential to understanding how AAs contribute to the overall issue of crowding.

scholarly journals Effects of stimulus parameters on motor seizure duration in electroconvulsive therapy

2017 ◽  
Vol Volume 13 ◽  
pp. 1427-1434 ◽  
Author(s):  
Sungwoo Joo ◽  
YeonHo Joo ◽  
Chang Yoon Kim ◽  
JungSun Lee
Keyword(s):  
Electroconvulsive Therapy ◽  
Seizure Duration ◽  
Motor Seizure ◽  
Stimulus Parameters

scholarly journals Computerised EEG Monitoring for Carotid Endarterectomy

1986 ◽  
Vol 14 (1) ◽  
pp. 32-36 ◽  
Author(s):  
A. B. Baker ◽  
A. J. Roxburgh
Keyword(s):  
Prospective Study ◽  
Carotid Endarterectomy ◽  
Cerebral Ischaemia ◽  
Eeg Monitoring ◽  
Spectral Edge Frequency ◽  
Spectral Edge ◽  
Significant Events ◽  
Eeg Power ◽  
Definition Of ◽  
A Prospective Study

A prospective study was undertaken in twenty patients undergoing carotid endarterectomy using computerised EEG monitoring in the form of a density-modulated spectral array, spectral edge frequency and integrated EEG power for monitoring cerebral ischaemia. This form of monitoring proved to be easy to use and understand. Because ischaemic EEG events longer than one minute were not necessarily followed by postoperative deficits, the definition of significant events that would cause ischaemia may need to be modified.

The Onset and Rate of the Antidepressant Effect of Electroconvulsive Therapy

1993 ◽  
Vol 162 (6) ◽  
pp. 725-732 ◽  
Author(s):  
Allan I. F. Scott ◽  
Lawrence J. Whalley
Keyword(s):  
Electroconvulsive Therapy ◽  
Royal College ◽  
Mode Of Action ◽  
Depressive Disorders ◽  
Practical Interest ◽  
Antidepressant Effect ◽  
Rapid Improvement ◽  
Research Committee ◽  
Biological Studies ◽  
Antidepressant Effects

This annotation is concerned with how soon and at what rate antidepressant effects become apparent over a course of electroconvulsive therapy (ECT). The first question is of importance in the design and interpretation of biological studies of the mode of action of ECT. The second question is of practical interest to the treating psychiatrist when we ask how the speed of recovery is influenced by what the psychiatrist prescribes, that is, the number and frequency of treatments. These questions are little better answered now than 20 years ago. This may come as a surprise to many readers, who have been advised to use ECT when “seeking rapid improvement” in depressive disorders (ECT Sub-Committee of the Research Committee of the Royal College of Psychiatrists, 1989). This lack of progress is attributable to a dearth of appropriately designed ECT studies.

The Royal College of Psychiatrists' Memorandum on the Use of Electroconvulsive Therapy

1977 ◽  
Vol 131 (3) ◽  
pp. 261-272 ◽  
Keyword(s):  
Electroconvulsive Therapy ◽  
Royal College ◽  
Health Authority ◽  
Medical Officer ◽  
Regional Health Authority ◽  
Special Committee ◽  
Regional Health ◽  
Regional Authority ◽  
Regional Medical

A Special Committee of the College was appointed in May 1976 after the President had received a request from Dr Porter, the Regional Medical Officer of the SE Thames Regional Health Authority, for the College's advice on the problems of administration of ECT, especially when consent is withheld or given reluctantly. Although the Regional Authority had been concerned earlier with the problem, the situation which prompted further action was the publication in March of the Report of the Inquiry on St Augustine's Hospital, pages 63–71 of which dealt with the administration of ECT and recommended that the College ‘should give urgent consideration to these problems and issue clear guidance’.

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