Electroencephalographic Changes Following Electrically Induced Focal Seizures

Bergman, Philip S.; Impastato, David J.; Berg, Seymour; Feinstein, Rhoda

doi:10.1159/000105424

Cited by 6 publications

(4 citation statements)

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“…The results confirm the anecdotal report of Bergman et al (1953) that after unilateral ECT there are signs of neurological dysfunction, referable to the treated hemisphere. In the present study we found that most of the induced convulsions, although bilateral, were asymmetrical and were followed by left/right differences in reflex activity and motor power.…”

Section: Discussionsupporting

confidence: 89%

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Neurological asymmetries immediately after unilateral ECT.

Kriss¹,

Blumhardt²,

Halliday³

et al. 1978

Journal of Neurology, Neurosurgery & Psychiatry

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Diseases, Queen Square, London S U M M A R Y Twenty-nine right handed patients were examined neurologically before and immediately after each of 62 unilateral ECTs to the dominant and non-dominant hemispheres. Most convulsions were followed by signs of transitory neurological dysfunction referable to the treated hemisphere. These signs included deep tendon reflex asymmetry, hemiparesis, tactile and visual inattention, and homonymous hemianopia. After treatment to the right hemisphere some patients had left visuospatial neglect, while all patients who had dominant hemisphere ECT were transiently dysphasic. All neurological abnormalities tested resolved within 20 minutes of treatment.We have previously reported results of separate electrophysiological investigations in which the EEG, flash evoked potential (VEP), and somatosensory evoked potential (SEP) were monitored during the half hour period after unilateral ECT (Kriss et al., 1975(Kriss et al., , 1977a(Kriss et al., ,b, 1978. Briefly, these studies showed that during the induced seizure the EEG had significantly larger epileptic slow wave activity on the treated side. In the immediate postictal period there was a clear asymmetry with the treated side producing significantly more delta and less alpha and beta activity than the contralateral side. These hemisphere differences, though becoming less marked, persisted beyond the end of the recording. Evoked potential studies showed differing results for the flash VEP and SEP. The VEP was markedly asymmetrical for 15 minutes after the shock with the major positive component (P140) being significantly smaller and later on the treated side. The SEP, however, showed no significant hemisphere differences. In view of these findings we decided to examine patients during the immediate post-ictal period to determine whether there was any clinical evidence of concomitant dysfunction, and to assess the severity and duration of any neurological asymmetries found.

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Section: Discussionsupporting

confidence: 89%

“…Transient neurological abnormalities after unilateral ECT have been referred to anecdotally but do not appear to have been studied systematically. In the introduction to their study of EEG changes after unilateral ECT Bergman et al (1953) simply state that on recovery of consciousness after treatment ". .…”

mentioning

confidence: 99%

Neurological asymmetries immediately after unilateral ECT.

Kriss¹,

Blumhardt²,

Halliday³

et al. 1978

Journal of Neurology, Neurosurgery & Psychiatry

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“…In general, the changes were less marked after focal seizures and they occurred in a smaller proportion of patients." [Bergman et al, 1953].…”

Section: Implications For Rtmsmentioning

confidence: 99%

“…Whether there is a relationship between background EEG activity and ECT therapeutic response has remained uncertain [Weiner, 1983;Sackeim et al, 1996;Krystal and Weiner, 1999]. Several studies have reported that greater EEG slowing was associated with a better therapeutic response [Proctor and Goodwin, 1943;Roth, 1951Roth, , 1952Roth et al, 1957;Fink and Kahn, 1957;Ottosson, 1962;Stromgren and Juul-Jensen, 1975;Abrams et al, 1987;Sackeim et al, 1996], whereas some studies reported poorer outcome with greater slowing [Honcke and Zahle, 1946;Mosovich and Katzenelbogen, 1948], and still others did not find any relationship between EEG slowing and therapeutic response [Taylor and Pacella, 1948;Chusid and Pacella, 1952;Bergman et al, 1953;Johnson et al, 1960;Ulett, 1962;Sutherland et al, 1969;Abrams et al, 1970Abrams et al, , 1972Volavka et al, 1972;Volavka, 1974;Kurland et al, 1976;Weiner et al, 1986a;Drake and Shy, 1989;Malaspina et al, 1994].…”

Section: Relationships Between the Background Eeg And The Therapeuticmentioning

confidence: 99%

EEG effects of ECT: Implications for rTMS

et al. 2000

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Electroconvulsive therapy (ECT) involves the use of electrical stimulation to elicit a series of generalized tonic–clonic seizures for therapeutic purposes and is the most effective treatment known for major depression. These treatments have significant neurophysiologic effects, many of which are manifest in the electroencephalogram (EEG). The relationship between EEG data and the response to ECT has been studied since the 1940s, but for many years no consistent correlates were found. Recent studies indicate that a number of specific EEG features recorded during the induced seizures (ictal EEG) as well as before and after a course of treatment (interictal EEG) are related to both the therapeutic efficacy and cognitive side effects. Similar to ECT, repetitive transcranial magnetic stimulation (rTMS), which involves focal electromagnetic stimulation of cortical neurons, has also been studied as an antidepressant therapy and also appears to have neurophysiologic effects, although these have not been as fully investigated as is the case with ECT. Given the similarity of these treatments, it is natural to consider whether advances in understanding the electrophysiologic correlates of the ECT response might have implications for rTMS. The present article reviews the literature on the EEG effects of ECT and discusses the implications in terms of the likely efficacy and side effects associated with rTMS in specific anatomic locations, the potential for producing an antidepressant response with rTMS without eliciting seizure activity, eliciting focal seizures with rTMS, and the possibility of using rTMS to focally modulate seizure induction and spread with ECT to optimize treatment. Depression and Anxiety 12:157–165, 2000. © 2000 Wiley‐Liss, Inc.

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Inhalant-Induced Convulsions

Fink¹

1961

Arch Gen Psychiatry

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Electroencephalographic Changes Following Electrically Induced Focal Seizures

Cited by 6 publications

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Neurological asymmetries immediately after unilateral ECT.

Neurological asymmetries immediately after unilateral ECT.

EEG effects of ECT: Implications for rTMS

Inhalant-Induced Convulsions

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