| A one-page course in Advanced Electroconvulsive Therapy | ||
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This sample ECT report of the Thymatron® System IV shows that the doctor set the % Energy dial to the patient's age of 45 years, yielding a 308 mC stimulus charge. The Optimal Charge Rate Program selected a 1/4 msec pulsewidth, 70 Hz frequency stimulus delivered over 7.2 sec. Prior to stimulus administration the impedance measured a safe 1440 ohms, which dropped to 260 ohms during stimulus delivery.
The EEG seizure lasted 48 seconds. Peak seizure amplitude was reached at 31 sec, with a Midictal Amplitude of 264 µV, a Maximum Sustained Power of 77841 µV2, and an Average Seizure Energy Index of 72µV2 all reflecting strong seizure intensity. Peak Interhemispheric Coherence reached at 33 sec was consistent with the seizure amplitude peak at 31 sec. The Maximum Sustained Coherence value of 95% reflected synchronous participation of both hemispheres in the seizure. The rapid drop of EEG seizure amplitude to 10 µV postictally yielded a high Postictal Suppression Index of 96%. Power Spectral Analysis was not enabled. In summary, the record shows a synchronous, high-intensity, well-developed, and well-generalized EEG seizure pattern with a strong mid-ictal phase, pronounced postictal suppression, and a substantial tachycardia response—which is to say, an ECT-induced seizure of high expected clinical efficacy (Abrams, 2002). |
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