RESUMO
Pulmonary edema after electroconvulsive therapy (ECT) is a rarely reported condition that can result in serious morbidity and even death if not promptly recognized and treated. We report the case of 21-year-old man with FG syndrome and schizophrenia who developed negative-pressure pulmonary edema after his 28th ECT. The patient developed acute hypoxemia requiring positive-pressure ventilation and was observed overnight in the intensive care unit. He recovered fully and received 43 subsequent ECT treatments without complication. This case illustrates the importance of taking steps to prevent airway obstruction as well as recognizing this rare but serious complication.
Assuntos
Anestesia Geral , Eletroconvulsoterapia/efeitos adversos , Edema Pulmonar/etiologia , Esquizofrenia/terapia , Anormalidades Múltiplas/genética , Doença Aguda , Adulto , Agenesia do Corpo Caloso , Agressão/psicologia , Obstrução das Vias Respiratórias/complicações , Pressão Atmosférica , Cromossomos Humanos X , Relação Dose-Resposta a Droga , Humanos , Deficiência Intelectual/genética , Laringismo/complicações , Masculino , Fármacos Neuromusculares Despolarizantes/administração & dosagem , Fármacos Neuromusculares Despolarizantes/efeitos adversos , Oxigenoterapia , Edema Pulmonar/terapia , Fatores de Risco , Esquizofrenia/genética , Aberrações dos Cromossomos Sexuais , Succinilcolina/administração & dosagem , Succinilcolina/efeitos adversos , SíndromeRESUMO
We report on the use of electroconvulsive therapy (ECT) in a 20-year-old man with a history of FG syndrome and schizophrenia who demonstrated thought disorder and aggression refractory to pharmacological treatment. He received 71 ECT treatments over a period of 13 months and demonstrated a marked reduction in aggressive behavior. In the 14 months before beginning ECT, the patient spent 189 days in the hospital, whereas in the 13 months subsequent to his initial ECT series as an inpatient, he was able to be maintained in the community without psychiatric hospitalization. This case extends the findings of prior cases documenting the alleviation of aggressive behaviors with ECT.
