Management of severe postictal agitation after electroconvulsive therapy with bispectrum electroencephalogram index monitoring: a case report

Postictal agitation (PIA) with possible severe implications occurs in approximately 10% of electroconvulsive therapy (ECT) sessions. The pathomechanism is not well understood, and suggested treatments are empirical based. We report a case of repetitive (47/57 sessions [83%]) severe PIA after ECT in...

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Hauptverfasser: Kranaster, Laura (VerfasserIn) , Janke, Christoph (VerfasserIn) , Sartorius, Alexander (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2012/06/01
In: The journal of ECT
Year: 2012, Jahrgang: 28, Heft: 2, Pages: e9-e10
ISSN:1533-4112
DOI:10.1097/YCT.0b013e31823d2fef
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1097/YCT.0b013e31823d2fef
Verlag, Volltext: https://insights-ovid-com.ezproxy.medma.uni-heidelberg.de/crossref?an=00124509-201206000-00025
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Verfasserangaben:Laura Kranaster, Christoph Janke, Carolin Hoyer, Alexander Sartorius

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520 |a Postictal agitation (PIA) with possible severe implications occurs in approximately 10% of electroconvulsive therapy (ECT) sessions. The pathomechanism is not well understood, and suggested treatments are empirical based. We report a case of repetitive (47/57 sessions [83%]) severe PIA after ECT in a case with severe depression. If the minimal bispectrum EEG index (BIS) value, meaning the deepest level of sedation of the thiopental narcosis dropped below 50, PIA occurred in only 9.1%. Bispectral index (BIS) monitoring made prediction and prevention of PIA possible to some degree. Postictal agitation might occur in vulnerable patients when initial depth of anesthesia is too light. 
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