Left Anterior-Right Temporal Electroconvulsive Therapy for Catatonia After Epilepsy Surgery: A Case Report.

Abstract

Psychiatric Rating Scale (BPRS), the Montgomery and Asberg Modified Scale (MADRS) and the Montreal Cognitive Assessment Scale (MoCA), at baseline and after 6 sessions. All have been validated (BPRS and MoCA) or adapted (MADRS) for use in the Portuguese population. Pretreatment and immediate posttreatment scores were as follows: BPRS, 42 and 29 (30.95% reduction); MADRS, 3 and 1 (66.7% reduction); and MOCA, 13 and 20 (53.85% improvement). Mental state examination showed marked improvement in thought organization and delusional beliefs. There were no apparent adverse effects, and the patient tolerated all treatment procedures easily. The patient was discharged with clozapine 300 mg QD and haloperidol decanoate 100 mg monthly. Although maintenance ECTwas offered, the patient dropped out after 3 maintenance treatments. Nevertheless, after 12 weeks of being treated only with haloperidol and clozapine, at equivalent or lower doses than those previously ineffective, the benefit obtained with ECT was sustained or enhanced: BPRS, 26 (38.09% reduction); MADRS, 0 (100% reduction); and MoCA, 23 (76.92% improvement).