Inflammation-Related Non-Infectious Febrile Reaction Induced by Electroconvulsive Therapy in a Young Female with Bipolar Disorder: A Case Report and Literature Review.

Abstract

Electroconvulsive therapy (ECT) has been employed as an effective treatment for refractory psychiatric disorders worldwide. Despite its extensive use, the occurrence of a fever following ECT has been rare and seldom documented. The reasons behind a post-ECT fever could vary; instances solely attributed to inflammation have been scarcely reported. We present the case of a 27-year-old woman diagnosed with bipolar disorder who experienced multiple fever episodes after having ECT. Diagnostic tests revealed elevated C-reactive protein (CRP) levels with no other infectious focus or possibility of neuroleptic malignant syndrome. We propose that this febrile reaction without real infection was related to inflammatory response triggered by ECT, with the release of various neurotransmitters into the brain and changes in the microsystems. Under this impression, we can speculate that it is a benign and reversible process, allowing us to continue ECT and achieve therapeutic efficacy. This might be the first report to suggest that an ECT-induced fever is related to inflammatory reactions.