ELECTROCONVULSIVE THERAPY FOR AGITATION IN LEWY BODIES DEMENTIA

Introduction Dementia with Lewy Bodies (DLB) is a primary degenerative dementing syndrome characterized by visual hallucinations, fluctuation in cognition, depressive symptoms and parkinsonism. Literature has shown the utility of electroconvulsive therapy (ECT) demented patients regarding agitation. Nevertheless, majority cases described include vascular dementia Alzheimer’s disease. There are no informed concerning ECT DLB agitation aggressive behaviors. Objectives Evaluate impact for patient diagnosis (DLB). Methods Case report. 68-year-old male, prior neuropsychiatric history, was present psychiatric evaluation 5 year history progressive fluctuations complex delusional beliefs, mood, anhedonia, irritability, associated to parkinsonism increasing autoaggressive behaviors An extensive neurologic workup including neuroimaging, EEG laboratory studies failed reveal specific etiology. Neuropsychological testing reveals frontal, attentional, visuospatial dysfunction. A presumptive made. Medication trials donepezil, memantine, lamotrigine, sertraline, quetiapine, risperidone melatonin manage his depressive, psychotic behavioral disturbances. Results Considering past medication failures prominent disturbances family consented an acute course ECT. Initial phase consisted 6 sessions right unilateral, brief pulse width (0.3 ms) tri-weekly utilizing Mecta Spectrum. Anesthesia induced propofol, received succinylcholine muscle relaxation. charge 115 mC (6x seizure threshold), then raised 192 mC. Seizure duration averaged 22 seconds. No adverse reactions reported. Clinical outcomes were measured CGI-Efficacy Index. Pre-ECT CGI-SI score (severely ill) post-ECT CGI-I 3 (minimally improved). Conclusions Mood frequent motive consultations patients. The treatment challenging due sensitivity antidopaminergic medications evidenced this type This case suggests that aggression patients, although further investigation needed. Disclosure Interest None Declared