Use of ECT in Major Vascular Neurocognitive Disorder with Treatment-Resistant Behavioral Disturbance following an Acute Stroke in a Young Patient
The following case describes the utilization of bitemporal ECT as a treatment of last resort in a 47-year-old woman with profoundly treatment-resistant behavioral disturbance poststroke. The use of ECT led to improvement in symptoms sufficient for discharge from an inpatient psychiatric unit to the...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2019/9694765 |
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| _version_ | 1832564432735043584 |
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| author | Kyle E. Rodenbach Daniel Varon Timothey Denko Ryan Peterson Carmen Andreescu |
| author_facet | Kyle E. Rodenbach Daniel Varon Timothey Denko Ryan Peterson Carmen Andreescu |
| author_sort | Kyle E. Rodenbach |
| collection | DOAJ |
| description | The following case describes the utilization of bitemporal ECT as a treatment of last resort in a 47-year-old woman with profoundly treatment-resistant behavioral disturbance poststroke. The use of ECT led to improvement in symptoms sufficient for discharge from an inpatient psychiatric unit to the nursing home. Neuropsychiatric sequelae of stroke include poststroke depression, anxiety, mania, psychosis, apathy, pathological laughter and crying, catastrophic reaction, and mild and major vascular neurocognitive disorders. Behavioral disturbance is common and may pose diagnostic and therapeutic difficulty in the poststroke patient. In most cases, first-line treatment includes pharmacologic intervention tailored to the most likely underlying syndrome. Frequent use of sedating medications is a more drastic option when behaviors prove recalcitrant to first-line approaches and markedly affect quality of life and patient safety. ECT is generally safe, is well tolerated, and may be effective in improving symptoms in treatment-resistant behavioral disturbance secondary to stroke with major neurocognitive impairment, as suggested in this case. |
| format | Article |
| id | doaj-art-c9522509c0f74d03bda6917d288014b9 |
| institution | Kabale University |
| issn | 2090-682X 2090-6838 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-c9522509c0f74d03bda6917d288014b92025-02-03T01:11:05ZengWileyCase Reports in Psychiatry2090-682X2090-68382019-01-01201910.1155/2019/96947659694765Use of ECT in Major Vascular Neurocognitive Disorder with Treatment-Resistant Behavioral Disturbance following an Acute Stroke in a Young PatientKyle E. Rodenbach0Daniel Varon1Timothey Denko2Ryan Peterson3Carmen Andreescu4University of Pittsburgh Medical Center, Department of Psychiatry, 3811 O’Hara Street, Pittsburgh, PA 15213, USAUniversity of Pittsburgh Medical Center, Department of Psychiatry, 3811 O’Hara Street, Pittsburgh, PA 15213, USAUniversity of Pittsburgh Medical Center, Department of Psychiatry, 3811 O’Hara Street, Pittsburgh, PA 15213, USAUniversity of Pittsburgh Medical Center, Department of Psychiatry, 3811 O’Hara Street, Pittsburgh, PA 15213, USAUniversity of Pittsburgh Medical Center, Department of Psychiatry, 3811 O’Hara Street, Pittsburgh, PA 15213, USAThe following case describes the utilization of bitemporal ECT as a treatment of last resort in a 47-year-old woman with profoundly treatment-resistant behavioral disturbance poststroke. The use of ECT led to improvement in symptoms sufficient for discharge from an inpatient psychiatric unit to the nursing home. Neuropsychiatric sequelae of stroke include poststroke depression, anxiety, mania, psychosis, apathy, pathological laughter and crying, catastrophic reaction, and mild and major vascular neurocognitive disorders. Behavioral disturbance is common and may pose diagnostic and therapeutic difficulty in the poststroke patient. In most cases, first-line treatment includes pharmacologic intervention tailored to the most likely underlying syndrome. Frequent use of sedating medications is a more drastic option when behaviors prove recalcitrant to first-line approaches and markedly affect quality of life and patient safety. ECT is generally safe, is well tolerated, and may be effective in improving symptoms in treatment-resistant behavioral disturbance secondary to stroke with major neurocognitive impairment, as suggested in this case.http://dx.doi.org/10.1155/2019/9694765 |
| spellingShingle | Kyle E. Rodenbach Daniel Varon Timothey Denko Ryan Peterson Carmen Andreescu Use of ECT in Major Vascular Neurocognitive Disorder with Treatment-Resistant Behavioral Disturbance following an Acute Stroke in a Young Patient Case Reports in Psychiatry |
| title | Use of ECT in Major Vascular Neurocognitive Disorder with Treatment-Resistant Behavioral Disturbance following an Acute Stroke in a Young Patient |
| title_full | Use of ECT in Major Vascular Neurocognitive Disorder with Treatment-Resistant Behavioral Disturbance following an Acute Stroke in a Young Patient |
| title_fullStr | Use of ECT in Major Vascular Neurocognitive Disorder with Treatment-Resistant Behavioral Disturbance following an Acute Stroke in a Young Patient |
| title_full_unstemmed | Use of ECT in Major Vascular Neurocognitive Disorder with Treatment-Resistant Behavioral Disturbance following an Acute Stroke in a Young Patient |
| title_short | Use of ECT in Major Vascular Neurocognitive Disorder with Treatment-Resistant Behavioral Disturbance following an Acute Stroke in a Young Patient |
| title_sort | use of ect in major vascular neurocognitive disorder with treatment resistant behavioral disturbance following an acute stroke in a young patient |
| url | http://dx.doi.org/10.1155/2019/9694765 |
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