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Biomedical subjects

D. P. Devanand

Publications and source records attributed to D. P. Devanand.

11 recordsLinked to original sources
PubMed1989

Clinical Features and Predictors of Postictal Excitement.

In a retrospective case control study, clinical features of postictal excitement following electroconvulsive therapy (ECT) were examined in 24 patients and 24 matched controls. The two groups did not differ in clinical outcome, degree of pretreatment agitation, anesthetic or succinylcholine dose, number of ECTs received, mean seizure duration, number of titrated treatments with subconvulsive stimulation, or type of EEG ending. Patients who became excited early in the treatment course rarely manifested this phenomenon at all subsequent treatments. Within the "excited" group, a minority of patients became excited following the first ECT, and only 34.3% of their treatments resulted in postictal excitement. It may not be necessary to routinely use postseizure benzodiazepines in patients who have once exhibited a postictal excitement.

Journal Article↗
PubMed1988

Seizure Elicitation Blocked by Pretreatment with Lidocaine.

A patient is reported in whom pretreatment with intravenous lidocaine resulted in failure to elicit a seizure even at stimulus intensity markedly greater than that used successfully at prior and subsequent treatments. Together with one other report, this experience suggests that lidocaine may prevent a seizure by raising the seizure threshold. An alternative explanation is proposed for the classic findings of Ottosson that lidocaine-modified seizures are reduced in therapeutic efficacy.

Journal Article↗
PubMed1987

Subjective Side Effects Acutely Following ECT: Associations with Treatment Modality and Clinical Response.

Patient reports of systemic side effects and cognitive impairment were obtained the afternoon of each treatment during the electroconvulsive therapy (ECT) course. Side effects were grouped a priori as reflecting physical complaints, perceived cognitive impairment, and as mood-related. Patients randomly assigned to bilateral ECT reported more cognitive impairment than patients who received right unilateral ECT. There were indications that the unilateral ECT group had greater physical/somatic complaints. Patients who responded to ECT differed from nonresponders only on the more explicitly mood-related items. Generally, the findings supported the desirability of extending studies of patient reports of ECT adverse effects to include subjective systemic side effects in addition to subjective cognitive impairment.

Journal Article↗
PubMed1987

Modified ECT Using Succinylcholine After Remission of Neuroleptic Malignant Syndrome.

The authors report two patients with a history of neuroleptic malignant syndrome (NMS) who were treated with ECT using succinylcholine as muscle relaxant, without ensuing complications. Most, though not all, of the evidence suggests that NMS is primarily central in origin in contrast to malignant hyperthermia, which is due to a genetic defect in skeletal muscle. Regardless of the theoretical debate over the origin of the high temperatures noted in NMS, reports to date suggest that modified ECT using succinylcholine can be safely used after remission of an episode of NMS.

Journal Article↗
PubMed1986

ECT-Induced Myoclonus.

We report a case of electroconvulsive therapy (ECT)-induced myoclonus which occurred postictally following every treatment and was distinguished from continuing seizure activity by electroencephalogram (EEG) recordings. Subsequent treatment with amitriptyline resulted in an isolated episode of myoclonus that did not recur when the dosage of medication was increased. Besides the clinical implications, this sequence of events raises questions about the serotonin hypothesis of antidepressant-induced myoclonus.

Journal Article↗