The history of electroconvulsive therapy in the treatment of neurological disorders

Raymond FABER

Departments of Psychiatry and Medicine (Neurology), UTHSCSA
7400 Merton Minter 116-A, San Antonio, Texas 78284, USA
Tel. 210-6175300, Fax. 210-9493306
<faber@uthscsa.edu>

 

The use of electroconvulsive therapy (ECT) in the treatment of neurological disorders is not widely appreciated, yet ECT can be remarkably useful in the treatment of movement disorders and seizure disorders. This presentation will describe the evolution of ECT in the treatment of neurological disorders, as ECT is an important node where neurology and psychiatry intersect.

The first report on the use of ECT in Parkinson's disease (PD) was in 1947 as incidental mention in a geriatric series. The first case report of ECT clearly improving the motor disabilities of PD was by Kalinowsky in 1949. In 1957 Fromm reported the first case series on 8 patients with PD treated with ECT, 5 of the 8 had clinical improvement. Sporadic case reports and case series did not reappear until 1975, culminating in the 1987 publication of a double-blind sham-controlled study of eleven patients by Swedish investigators with quite favorable results. Recent articles have examined the duration of benefit and the management of side effects. The literature now contains over one hundred case reports. Other movement disorders, including tardive dyskinesia, tardive dystonia, and Parkinsonian variants, also improve with ECT. ECT can also be of benefit in seizure disorders. Sporadic case reports since 1943 describe transient reductions in seizure frequency for intractable seizures poorly responsive to medication and in status epilepticus. This benefit is believed to occur as a result of ECT raising the seizure threshold.

In addition to reviewing the pertinent literature, a brief videotape of patients with movement disorders benefiting from ECT will be shown.

 

Panel 7B   (Prolonged Baths)
Friday, 17 September 1999
12.30

The Neurosciences and Psychiatry: Crossing the Boundaries

Joint Congress of the European Association for the History of Psychiatry (EAHP), the European Club for the History of Neurology (ECHN), and the International Society for the History of the Neurosciences (ISHN)

Zurich and Lausanne, Switzerland, 13-18 September 1999