Two children aged 13 and 10 years with intractable epilepsy were treated with electroconvulsive therapy (ECT) for seizure control at the Children’s Hospital, Charleston, SC. A change in pattern but incomplete control of spontaneous seizures followed alternate-day ECT, and a series of 3 ECT seizures during a single session of anesthesia stopped spontaneous seizures and reduced the frequency of tonic seizures. ECT raised the ECT seizure threshold, was effective in ending nonconvulsive status, but benefits were transient and the value questionable. [1]

COMMENT. Repeated electroshock seizures in laboratory animals results in an increase in the electroshock threshold and the necessity for a stronger current to induce a seizure. The rather barbaric nature of ECT and fear of causing further brain damage have probably deterred pediatric neurologists from using this method of treatment in children with refractory epilepsy, but the American Psychiatric Association condones its use in adults and psychiatrists have reported its efficacy since the 1940s. I am in agreement with the present authors who question whether ECT offers a reasonable option for treating intractable epilepsy in children, and other forms of medical or surgical therapy would seem preferable.