Transient Fever Response After ECT in a Patient with Catatonic Schizophrenia: A Case Report.

Anıl Alp, Melike Karaçam Doğan, Elçin Özçelik Eroğlu, Mevhibe İrem Yildiz, Şeref Can Gürel, Suzan Özer
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Abstract

Electroconvulsive therapy (ECT) is an effective and safe treatment method for many psychiatric disorders. In general medical practice, ECT may cause side effects as most other treatment methods do. Headache, myalgia, nausea, vomiting, confusion, anterograde amnesia are common side effects of electroconvulsive therapy. Fever; in addition to general medical conditions such as infection, malignancy, connective tissue diseases, drug treatments, malignant hyperthermia, convulsions, it can also occur due to conditions such as neuroleptic malignant syndrome (NMS), serotonin syndrome, catatonia, malignant catatonia, which are frequently encountered in psychiatry clinics. In the literature, transient fever response due to electroconvulsive therapy application have been described, albeit rarely. Although there are many proposed mechanisms for the emergence of a fever response, regardless of its cause, it is still not understood why some fever responses occur. In this article, we present the differential diagnosis of the fever response, possible causes, and the mechanisms that may reveal the secondary fever response to electroconvulsive therapy in a case with a diagnosis of catatonic schizophrenia, who developed a fever response during electroconvulsive therapy sessions and no fever response was observed at times other than electroconvulsive therapy sessions. In this case, postictal benign fever response associated with electroconvulsive therapy was considered after excluding other medical conditions that may cause a fever response after electroconvulsive therapy. Keywords: ECT, Fever, Catatonia, NMS.

一名紧张性精神分裂症患者电痉挛疗法后的短暂发热反应:病例报告。
电休克疗法(ECT)是治疗多种精神疾病的有效而安全的方法。在一般医疗实践中,电休克疗法与大多数其他治疗方法一样,可能会产生副作用。头痛、肌痛、恶心、呕吐、精神错乱、逆行性遗忘是电休克疗法常见的副作用。发热;除了感染、恶性肿瘤、结缔组织疾病、药物治疗、恶性高热、惊厥等一般内科疾病外,神经安定剂恶性综合征(NMS)、5-羟色胺综合征、紧张症、恶性紧张症等精神科门诊经常遇到的疾病也会导致发热。在文献中,也有因应用电休克疗法而出现一过性发热反应的描述,尽管这种情况很少见。尽管有许多关于发热反应出现机制的建议,但无论其原因如何,人们仍然不明白为什么会出现一些发热反应。在本文中,我们介绍了发热反应的鉴别诊断、可能的原因,以及可能揭示电休克治疗继发性发热反应的机制,该病例被诊断为紧张性精神分裂症,在电休克治疗过程中出现发热反应,而在电休克治疗以外的时间则未观察到发热反应。在本病例中,在排除了其他可能导致电休克治疗后发热反应的疾病后,考虑到了与电休克治疗相关的发作后良性发热反应。关键词电休克 发热 卡他性精神障碍 NMS
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