Dr. Bailine is the Chief of the ECT Service at the Long Island Jewish Hillside Medical Center in Glen Oaks, New York. He introduced the use of flumazenil to improve seizure quality in patients who had received high doses of benzodiazepines. He also introduced the use of bifrontal electrode placement to his service in 1995. Even when we treat our adolescent patients with very low electrical doses, many have prolonged seizures. Usually, the seizures stop spontaneously, but in some instances they exceed 180 seconds, our arbitrary end-point.
Propofol anesthesia shortens seizure length.
Our patients have had shorter, but still very adequate, seizures by EEG criteria. The need to interrupt a prolonged seizure with additional drugs has been eliminated. Post-ECT nausea was also reduced and the patients have had quicker recoveries. The elicited seizure was prolonged. The patient experienced a motor seizure of 60 seconds and an EEG seizure of 70 seconds.