Neurocritical Care

, Volume 12, Issue 2, pp 204–210

Electroconvulsive Therapy for Refractory Status Epilepticus: A Case Series

  • Hooman Kamel
  • Susannah Brock Cornes
  • Manu Hegde
  • Stephen E. Hall
  • S. Andrew Josephson
Original Article



Status epilepticus refractory to conventional anti-epileptic drugs typically has a poor prognosis, but patients may recover well if seizures can be stopped. Case reports suggest that electroconvulsive therapy (ECT) may stop seizures in patients with refractory status epilepticus, and we sought to examine its effectiveness in a series of patients.


Three consecutive patients with refractory status epilepticus at our institution were treated with ECT after other therapies had failed.


ECT stopped seizures in 2 of 3 patients. One patient had complete neurological recovery; the other was left with mild cognitive impairment and epilepsy, but returned to independent living.


ECT may be an effective therapy for refractory status epilepticus and warrants further study for this indication.


Status epilepticus Electroconvulsive therapy Anticonvulsants 


  1. 1.
    Rosenow F, Hamer HM, Knake S. The epidemiology of convulsive and nonconvulsive status epilepticus. Epilepsia. 2007;48(Suppl 8):82–4.CrossRefPubMedGoogle Scholar
  2. 2.
    Treatment of convulsive status epilepticus. Recommendations of the Epilepsy Foundation of America’s Working Group on Status Epilepticus. JAMA. 1993;270:854–9.Google Scholar
  3. 3.
    Arif H, Hirsch LJ. Treatment of status epilepticus. Semin Neurol. 2008;28:342–54.CrossRefPubMedGoogle Scholar
  4. 4.
    Chen JW, Wasterlain CG. Status epilepticus: pathophysiology and management in adults. Lancet Neurol. 2006;5:246–56.CrossRefPubMedGoogle Scholar
  5. 5.
    Nevander G, Ingvar M, Auer R, Siesjo BK. Status epilepticus in well-oxygenated rats causes neuronal necrosis. Ann Neurol. 1985;18:281–90.CrossRefPubMedGoogle Scholar
  6. 6.
    Mayer SA, Claassen J, Lokin J, Mendelsohn F, Dennis LJ, Fitzsimmons BF. Refractory status epilepticus: frequency, risk factors, and impact on outcome. Arch Neurol. 2002;59:205–10.CrossRefPubMedGoogle Scholar
  7. 7.
    Mirsattari SM, Sharpe MD, Young GB. Treatment of refractory status epilepticus with inhalational anesthetic agents isoflurane and desflurane. Arch Neurol. 2004;61:1254–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Robakis TK, Hirsch LJ. Literature review, case report, and expert discussion of prolonged refractory status epilepticus. Neurocrit Care. 2006;4:35–46.CrossRefPubMedGoogle Scholar
  9. 9.
    Viparelli U, Viparelli G. ECT and grand mal epilepsy. Convuls Ther. 1992;8:39–42.PubMedGoogle Scholar
  10. 10.
    Carrasco Gonzalez MD, Palomar M, Rovira R. Electroconvulsive therapy for status epilepticus. Ann Intern Med. 1997;127:247–8.PubMedGoogle Scholar
  11. 11.
    Griesemer DA, Kellner CH, Beale MD, Smith GM. Electroconvulsive therapy for treatment of intractable seizures. Initial findings in two children. Neurology. 1997;49:1389–92.PubMedGoogle Scholar
  12. 12.
    Lisanby SH, Bazil CW, Resor SR, Nobler MS, Finck DA, Sackeim HA. ECT in the treatment of status epilepticus. J ECT. 2001;17:210–5.CrossRefPubMedGoogle Scholar
  13. 13.
    Cline JS, Roos K. Treatment of status epilepticus with electroconvulsive therapy. J ECT. 2007;23:30–2.CrossRefPubMedGoogle Scholar
  14. 14.
    Sackeim HA, Decina P, Prohovnik I, Malitz S, Resor SR. Anticonvulsant and antidepressant properties of electroconvulsive therapy: a proposed mechanism of action. Biol Psychiatry. 1983;18:1301–10.PubMedGoogle Scholar
  15. 15.
    Sackeim HA. The anticonvulsant hypothesis of the mechanisms of action of ECT: current status. J ECT. 1999;15:5–26.PubMedGoogle Scholar
  16. 16.
    Abrams R. The mortality rate with ECT. Convuls Ther. 1997;13:125–7.PubMedGoogle Scholar

Copyright information

© Humana Press Inc. 2009

Authors and Affiliations

  • Hooman Kamel
    • 1
  • Susannah Brock Cornes
    • 1
  • Manu Hegde
    • 1
  • Stephen E. Hall
    • 2
  • S. Andrew Josephson
    • 1
  1. 1.Department of NeurologyUniversity of CaliforniaSan FranciscoUSA
  2. 2.Department of PsychiatryUniversity of CaliforniaSan FranciscoUSA

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