A Case Report of Hemiplegia after Electroconvulsive Therapy and the Management of Subsequent Treatments

Abstract

Todd's paralysis), can only occur as a diagnosis of exclusion. The development of hemiplegia following ECT necessitates a timely and extensive evaluation with significant healthcare resource consumption.Upon searching PubMed for transient paralysis and electroconvulsive therapy, there appears to be very little report of this phenomenon in the literature [2][3][4][5][6][7][8]. Most reports of transient hemiplegia are in the context of unilateral electrical brain stimulation with resulting contralateral transient hemiplegia. There is no mention of whether subsequent ECT treatments will provoke recurrence of hemiplegia or the risk factors for such. Furthermore, while one study reported subsequent successful ECT treatments following an episode of transient hemiplegia [8], there are limited studies available to help guide recommendations for subsequent ECT treatments.The aim of this case report is to describe an episode of transient hemiplegia following ECT. An ultimate diagnosis of Todd's paralysis was made. The decision making process for whether or not to continue subsequent ECT treatments following an episode of transient hemiplegia will be discussed. HIPAA authorization has been obtained from the patient.

Todd Paralysis After Electroconvulsive Therapy—Letter to the Editor

“…These cases involved symptoms of facial paralysis, hemiparesis, and dysarthria, with symptom resolution occurring between 10 minutes and 10 days after onset. In 3 of 4 cases, neurology was consulted 2–4 . In 2 of the 4 cases, ECT treatment was continued after Todd paralysis, 2,5 and 1 case described switching the patient from unilateral to bilateral ECT, with no further complications 2 .…”