Management of Prolonged Seizures During Electroconvulsive Therapy

[5] Patients who have a prolonged seizure should undergo a review of their medications and history to determine risk factors, which could be addressed, including electrolyte disturbances, history of known seizure disorder, traumatic brain injury, hypoxia, pregnancy, medications such as lithium, theophylline, tricyclics, trazodone, caffeine or withdrawal from anti-convulsants, benzodiazepines or alcohol. [7] In summary, we note two additional steps, which can be taken to reduce the risk of prolonged seizures in ECT - prompt termination of any seizure activity at 120 seconds post-stimulus, and using propofol as the choice induction agent in patients with risk factors for a prolonged seizure, (including younger age groups).