Lifesaving Electroconvulsive Therapy for a Child With Autism Spectrum Disorder, Severe Self-Injurious Behavior, and Neuroleptic Malignant Syndrome

González-Romero, María Fernanda; Avina-Galindo, Ana Michelle; Elbe, Dean; Friedlander, Robin; Vila‐Rodriguez, Fidel

doi:10.1097/yct.0000000000000598

Cited by 9 publications

(6 citation statements)

References 5 publications

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“…66 Electroconvulsive therapy may also be effective in self-injurious behavior along the agitated catatonia spectrum and in self-injurious behavior and NMS. 70,71,123,124 One study found that self-injurious behavior in female patients was associated with poor outcome to ECT. 72…”

Section: Evidence For Ect In Self-injurious Behavior and Aggressionmentioning

confidence: 99%

Electroconvulsive Therapy in Children and Adolescents

Døssing

Pagsberg

2021

J ECT

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There is a lack of studies regarding the efficacy of electroconvulsive therapy (ECT) in children and adolescents. In this study, we aimed to assess benefits and harms of ECT in children and adolescents with major psychiatric diseases. We conducted a systematic search in PubMed, EMBASE, and PsycINFO for peer-reviewed articles written in English regarding the use of ECT as treatment for major psychiatric diseases in children and adolescents. This study consists of 192 articles, mostly case studies (n = 50), reviews and overview articles (n = 52), and retrospective studies (n = 30). We present an overview of evidence for ECT in children and adolescents with mood disorders, catatonia, schizophrenia, intellectual disability, self-injurious behavior, and other indications. This article is also a summary of international guidelines regarding the use of ECT in children and adolescents. We evaluated the overall quality of evidence by using Grading of Recommendations, Assessment, Development and Evaluations and found the overall level of evidence to be of low quality. There are no absolute contra indications for ECT in children and adolescents. Fears regarding cognitive dysfunction have not been reproduced in studies. Electroconvulsive therapy should be considered in severe, treatment-resistant mood disorders, catatonia, and schizophrenia, especially in older adolescents. High-quality studies are warranted to assess the efficacy of ECT, especially in these potentially life-threatening diseases.

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Section: Evidence For Ect In Self-injurious Behavior and Aggressionmentioning

confidence: 99%

Electroconvulsive Therapy in Children and Adolescents

Døssing

Pagsberg

2021

J ECT

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“…Clinical trials have proved that transcranial direct current stimulation (tDCS), 1 deep brain stimulation (DBS), 2 and electroconvulsive therapy (ECT) 3 have shown potency in neurology and psychiatry. More specifically, these therapies have been used clinically to treat cerebral ischemic diseases (epilepsy 4 and stroke 5 ), neurodegenerative diseases (Parkinson's syndrome 6 ), and genetic disorders (depression 7 and autism 8 ). However, most previous studies focused on observing changes in patients' physiological functions; they ignored the alteration of the mechanical properties and microscopic structure/compositions of the brain under local electric fields, even reports on this subject regarding ex vivo experiments.…”

Section: Introductionmentioning

confidence: 99%

The effects of electric fields on the mechanical properties and microstructure of ex vivo porcine brain tissues

Zhang

Zhao

2022

Soft Matter

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“…In patients with neuroleptic malignant syndrome, electroconvulsive therapy (ECT) helps with the alteration of temperature and level of consciousness. ECT should be considered in patients not responding to medical therapy in the first week, those in whom residual catatonia persists after other symptoms have resolved, and those in whom lethal catatonia is suspected as an alternative or concomitant disorder [32,33,36,37,38]. In a case series study of 15 patients who had neurocognitive or schizophrenia spectrum disorders and developed NMS after exposure to multiple antipsychotic drugs.…”

Section: The Role Of Electroconvulsive Therapy In Nmsmentioning

confidence: 99%

“…ECT is generally safe, however, serious treatment-related complications including cardiac arrest and ventricular fibrillation have been reported [32][33][34][35][36][37][38].…”

Section: The Role Of Electroconvulsive Therapy In Nmsmentioning

confidence: 99%

A Fatal Case of Prochlorperazine-Induced Neuroleptic Malignant Syndrome: A Case Report and Literature Review

Sharman¹

2019

AJMCR

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Neuroleptic malignant syndrome (NMS) is a medical emergency associated with the use of neuroleptics and antiemetics. NMS is characterized by a distinctive clinical syndrome of altered mental status, rigidity, hyperthermia, and autonomic dysfunction. NMS occurs as a result of changes in presynaptic or postsynaptic dopamine signaling. Central D2 receptor blockade in the hypothalamus, nigrostriatal pathways, and spinal cord leads to increased muscular rigidity and tremor via extrapyramidal pathways. Hypothalamic D2 receptor blockade results in an elevated temperature set point and impairment of heat-dissipating mechanisms. The reported mortality rates for NMS vary between 5 to 20 percent and the occurrence of medical complications and disease severity are the strongest predictors of mortality. This is a case of a 51 year old Caucasian female who presented with altered mental status, temperature of 109°F, diffuse muscular rigidity and autonomic dysfunction manifested as labile blood pressure, tachypnea, hypoxemia and tachycardia after consuming 18 tablets of Prochlorperazine over three days for gastrointestinal upset. Her clinical presentation and laboratory work up were consistent with NMS and she developed fatal complications and multi-organ dysfunction secondary to Prochlorperazine-induced neuroleptic malignant syndrome.

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Lifesaving Electroconvulsive Therapy for a Child With Autism Spectrum Disorder, Severe Self-Injurious Behavior, and Neuroleptic Malignant Syndrome

Abstract: We present a case of a preteen with autism spectrum disorder and severe self-injurious behavior who developed neuroleptic malignant syndrome on antipsychotics and required urgent electroconvulsive therapy and continued maintenance electroconvulsive therapy for ongoing clinical stability.

Cited by 9 publications

References 5 publications

Electroconvulsive Therapy in Children and Adolescents

Electroconvulsive Therapy in Children and Adolescents

The effects of electric fields on the mechanical properties and microstructure of ex vivo porcine brain tissues

A Fatal Case of Prochlorperazine-Induced Neuroleptic Malignant Syndrome: A Case Report and Literature Review

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