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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The unilateral and bilateral therapy differ in psycho-organic effects but have the same antidepressive efficiency. This is due to the facts that the organic effects are mainly caused by the electrical current whereas the antidepressive effect is dependent on the seizure activity. Compared to the bilateral treatment, unilateral gives reduced confusion, anterograde and retrograde amnesia as well as reduced experience of memory impairment. The difference is explained by a lower density of current in the brain. The unilateral treatment should be the treatment to be chosen. The antidepressive action of ECT fits the amine hypothesis, ECT causes a sustained increase of the synthesis of norepinephrine and of the sensitivity of amine receptors and creates conditions for alleviating both "low-output" and "low-sensitivity" depression. The antidepressive action is probably mediated by release of hypothalamic neurohormones.
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PMID:[Unilateral and bilateral shock therapy: mechanism of action (author's transl)]. 4 67

Double-blind studies of ACTH 4-10 and placebo were conducted in psychiatric patients receiving bilateral ECT to determine whether the polypeptide exerted anti-amnesic effects. Observations after a single ECT were suggestive of some positive effects, but studies between seizures after five or six ECTs showed no significant drug-placebo differences. Although the findings were largely negative, they do not rule out positive effects of ACTH 4-10 on memory. Possibly the designs and timing of the experiments and/or the dosages of ACTH 4-10 employed were unsuitable for demonstrating such influences.
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PMID:Effects of ACTH 4-10 on ECT-induced memory dysfunctions. 19 59

An intraindividual double-blind cross-over comparison for the anterograde effect on memory of unilateral non-dominant frontofrontal (FF) and temporo-parietal (TP) ECT was performed in connection with the second and third treatment of an ECT-series, the electrode placement being alternated at random. Treatment technique was standardized and seizure duration was measured by means of EEG. Memory functions were tested after treatments by means of four memory tests: the 30 Word-Pair Test, the 30 Figure Test, the 30 Geometrical Figure Test and the 30 Face Test. Three operationally defined memory variables, immediate memory (IMS, 3 hours after ECT), delayed memory (DMS, 3 hours after IMS), and their difference, forgetting, were scored. No differences were found in the mean time of electrical stimulation, in the amount of methohexital and suxamethonium chloride, and in seizure duration between the two treatment groups. No statistically significant differences in any of the memory tests were found. The FF electrode position did not show any advantage compared with the routine TP electrode placement.
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PMID:Comparison of fronto-frontal and temporo-parietal unilateral ECT. 33 77

In an an intra-individual crossover trial depressed patients were treated with the 5-hydroxytryptamine (5-HT) precursor L-tryptophan (L-TP) and unilateral ECT, or with unilateral ECT alone. The oral dose of L-TP was 6 g the day before ECT and 3 g on the day of ECT, 4 hours before the treatment. The seizure duration was measured on EEG records. The time of the electrical stimulation needed to induce generalized seizures was similar for both treatment alternatives. Thus L-TP seems not to elevate the threshold to ECT-induced convulsions. The mean duration of a seizure was significantly shorter when the patients were treated with L-TP + ECT than when treated with ECT alone. It is suggested that L-TP exerts an inhibitory influence on the ability to sustain epileptic activity.
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PMID:Has tryptophan any anticonvulsive effect? 64 14

EEG was continuously recorded in 15 patients for a period extending from just before to 1/2 hour after unilateral ECT. Fourier analysis was performed on the EEG following 15 right-sided treatments and five left-sided treatments. During the induced seizure, epileptic slow-wave activity had significantly greater power on the treated side. Immediately after the seizure, there was significantly more delta activity and less alpha and beta activity on the treated side. This asymmetry, though becoming less marked, was usually still present at the end of the recording period. Analysis of other variables associated with the treatment showed that there was a significant correlation between the time to eye-opening after ECT and both the duration of the seizure and the amount of anaesthetic administered. The similarity between these induced unilateral seizures and unilateral seizures occurring spontaneously in some epileptics is discussed.
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PMID:EEG immediately after unilateral ECT. 70 65

This study compares a low-energy brief-pulse stimulus (LEBS) with a conventional a-c sine wave stimulus in terms of electrical paramenters, efficiency in producing seizures, and clinical outcome on a variety of standard behavioral measures. The results show the LEBS to require equal voltage, less current, and only one-half the total energy to produce clinically manifest convulsions. There was no apparent difference between methods on any outcome measure. The Halstead-Reitan Neuropsychological Test Battery showed as many patients impaired prior to ECT as following treatment. Implications for ECT practices are discussed.
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PMID:A comparison of standard alternating current and low-energy brief-pulse electrotherapy. 88 85

The authors describe a portable electromyograph (EMG) designed for use in monitoring unilateral ECT. Administration of muscle relaxants in conjunction with ECT often makes it difficult to determine that an adequate response has been elicited. The authors feel that this adaptation of the EMG provides a useful and easy means of monitoring the presence, bilateralism, and length of the seizure.
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PMID:Portable electromyograph monitoring of unilateral ECT. 98 30

A double-blind, intra-individual cross-over comparison of the effect of piracetam on retrograde memory impairement as measured by the KS memory test battery was performed in connection with second and third Bi-ECT in 18 patients diagnosed as suffering from depression. The seizure duration and the post-ECT EGG patterns were examined visually and the post-ECT confusion time was measured. Piracetam was given orally in the dose of 4.8 g/day for 3 days. No significant effects were obtained on memory scores, electrical stimulus duration, EEG pattern or post-ECT confusion time. The findings may indicate that the protective effect of piracetam shown in animal electroconvuslive stimulation (ECS) is due to a counteraction of the disturbing effect of hypoxia on memory functions. It is concluded that more information is needed as regards the pharmacokinetics and the mode of action of the drug.
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PMID:Does piracetam counteract the ECT-induced memory dysfunctions in depressed patients? 109 38

The investigation concerned 100 patients with endogenous depression treated with ECT, 52 unilaterally on the non-dominant hemisphere, and 48 bilaterally. A double-blind investigation of the therapeutic effect and the effect on memory and on EEG was carried out. With unilateral treatment, mainly diffuse and same-sided EEG changes appeared, while with bilateral treatment mainly diffuse and left-sided changes occurred. Bilateral treatment led to significantly more EEG changes than did unilateral treatment. For both groups there was a tendency to greater changes after the last than after the sixth treatment. At termination of treatment, a significantly better therapeutic effect was found in cases where EEG changes appeared, especially severe EEG changes. This applied to the total material but not to the groups of unilaterals and bilaterals taken separately. In the entire material after the first six treatments, the greatest representation of patients with unchanged and impaired memory was found in cases with deteriorated EEG compared to cases with no EEG deterioration. After the entire series of ECT, this correlation no longer was present. After separation of the patients into unilaterals and bilaterals it was not present at any of the stages. In the bilateral group ECT treatment gave more frequent and stronger EEG changes, among the older than among the younger patients. For the unilateral group, there was no comparable difference. The number of weak seizures was significantly greater among the unilaterals than among the bilaterals. The therapeutic effect was not correlated to the number of weak seizures, but the number of weak seizures was positively correlated to the number of treatments applied.
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PMID:EEG in unilateral and bilateral electroconvulsive therapy. 109 39

Because induced seizures have such a fundamental influence on both beneficial and adverse effects associated with ECT, it is crucial that they be monitored as effectively as possible. In practice this process involves a combination of both motor and EEG monitoring. The technology for such monitoring, although not overly sophisticated, is also not trivial, and a certain amount of training is required before a practitioner can meaningfully interpret this type of information. Efforts to standardize monitoring practices, at least within a particular ECT program, are also indicated. Our knowledge of what constitutes an adequate seizure is limited, with duration still the primary focus. Future studies of ictal electrophysiology may well provide better answers in this regard. One area where already accomplished work has proved productive involves the delineation of many of the factors which influence seizure threshold and duration. On the basis of these data, practitioners now can exert considerably greater control over such measures, and thereby make more optimal use of this treatment modality.
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PMID:The monitoring and management of electrically induced seizures. 177 Nov 51


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