Recovery of Consciousness After E.C.T.

Abstract

The recovery phase of electrical convulsant therapy is of considerable psychological interest as it represents the process of re-establishment of cognitive and perceptual functions and a re-integration of personality. Thus, for present purposes the therapeutic implications are not considered; E.C.T. is regarded as an artificially induced, transient alteration of consciousness which permits an examination to be made of the recovery process. (1926) suggested that when functions disappear as a result of the administration of an agent such as chloroform they are lost "in order beginning with those of highest rank and culminating with the most mechanical and pre-ordained responses". He also suggested that there was a reciprocity between regression of and recovery of consciousness in that both processes followed the same steps but in opposite directions. Himwich (1951 ) confirmed Head's observation when he examined the return of neurological function during the recovery period in insulin coma treatment. PREVIOUS WORK HeadThere is also experimental evidence from animal studies. Wilcox (1955) quotes the work of Yoshii and Hiraiwa on rats which demonstrated that in the post ictal state the pattern of the simple spinal flexion reflex returned before its modification by the brain stem and, further, that recovery of both these functions precedes any demonstration of influence of cortex.Cohen (1939) reported his observations of a schizophrenic patient during the hour of recovery after metrazol-induced convulsions. He This work was begun in Manchester and completed in Glasgow. My thanks are due to Professor E. W. Anderson and to Professor T. Ferguson Rodger for their help and guidance.

Recovery of components of memory in post-traumatic amnesia

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Recovery of components of memory in post-traumatic amnesia

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Orientation and disorientation: Lessons from patients with epilepsy

“…An interesting characteristic of the postictal disorientation following ECT is its specific order of recovery across patients: patients recover their orientation firstly in person, secondly in space, and lastly in time [6,76,77]. This sequential recovery is not limited to postictal disorientation and may also be observed in patients recovering from disorientation following traumatic brain injury [58].…”

“…However, such a systematic investigation has been carried out in patients undergoing ECT, which induces generalized seizures [6]. Following ECT-induced seizures, there is commonly a period of disorientation in time, space, and person, which is resolved several hours later [6,76,77]. This disorientation leads to an inability to give correct answers to orientation questions in these domains.…”

Recovery of orientation after electroconvulsive therapy

“…In 13 studies, quantitative techniques were used to measure disorientation following ECT (Lunn & TrolZe (1949), Mowbray (1954Mowbray ( , 1959 …”

“…Six studies attempted a more precise determination of re-orientation by asking orientation questions more or less continuously after ECT (Mowbray (1954( , 1959( ), Lancaster et al (1958, Gottlieb & Wilson (1965), Valentine et al (1968), d'EZia (1970). Three of these studies were clear with regard to specifying ECT details and methods of measuring orientation (Mowbray (1954) Elia (1970)).…”

Recovery of components of memory in post-traumatic amnesia

“……”

Orientation and disorientation: Lessons from patients with epilepsy

“…An interesting characteristic of the postictal disorientation following ECT is its specific order of recovery across patients: patients recover their orientation firstly in person, secondly in space, and lastly in time [6,76,77]. This sequential recovery is not limited to postictal disorientation and may also be observed in patients recovering from disorientation following traumatic brain injury [58].…”

“…However, such a systematic investigation has been carried out in patients undergoing ECT, which induces generalized seizures [6]. Following ECT-induced seizures, there is commonly a period of disorientation in time, space, and person, which is resolved several hours later [6,76,77]. This disorientation leads to an inability to give correct answers to orientation questions in these domains.…”

Recovery of orientation after electroconvulsive therapy

“…In 13 studies, quantitative techniques were used to measure disorientation following ECT (Lunn & TrolZe (1949), Mowbray (1954Mowbray ( , 1959 …”

“…Six studies attempted a more precise determination of re-orientation by asking orientation questions more or less continuously after ECT (Mowbray (1954( , 1959( ), Lancaster et al (1958, Gottlieb & Wilson (1965), Valentine et al (1968), d'EZia (1970). Three of these studies were clear with regard to specifying ECT details and methods of measuring orientation (Mowbray (1954) Elia (1970)).…”

Recovery of components of memory in post-traumatic amnesia

“……”

Orientation and disorientation: Lessons from patients with epilepsy

“…An interesting characteristic of the postictal disorientation following ECT is its specific order of recovery across patients: patients recover their orientation firstly in person, secondly in space, and lastly in time [6,76,77]. This sequential recovery is not limited to postictal disorientation and may also be observed in patients recovering from disorientation following traumatic brain injury [58].…”

“…However, such a systematic investigation has been carried out in patients undergoing ECT, which induces generalized seizures [6]. Following ECT-induced seizures, there is commonly a period of disorientation in time, space, and person, which is resolved several hours later [6,76,77]. This disorientation leads to an inability to give correct answers to orientation questions in these domains.…”

Recovery of orientation after electroconvulsive therapy

“…In 13 studies, quantitative techniques were used to measure disorientation following ECT (Lunn & TrolZe (1949), Mowbray (1954Mowbray ( , 1959 …”

“…Six studies attempted a more precise determination of re-orientation by asking orientation questions more or less continuously after ECT (Mowbray (1954( , 1959( ), Lancaster et al (1958, Gottlieb & Wilson (1965), Valentine et al (1968), d'EZia (1970). Three of these studies were clear with regard to specifying ECT details and methods of measuring orientation (Mowbray (1954) Elia (1970)).…”