Cortical blindness after electroconvulsive therapy.

Electroconvulsive treatment (ECT) for mental disorders is considered to be safe and effective when administered according to standard protocols for appropriate indications.1-4 It can produce transient cognitive impairment, but not structural damage, to the brain and is remarkably free from serious complications. Deaths after ECT are reported to occur at a rate of 2 per 100,000 treatments, about the same as for general anesthesia,s and a task force of the American Psychiatric Association stated that there are no absolute contraindications to ECT.6 Bilateral occipital lobe brain hemorrhages also occur rarely; we found only six cases reported during the last two decades. None were caused by seizures, hypertension, trauma, or ECT.7-12 We report here a case of a man who had bilateral occipital lobe hemorrhages for which he was treated neurosurgically 9 days after receiving two electroconvulsive treatments for a severe depressive disorder that had been unresponsive to drug treatment. Based on the results of searches of MEDLINE and HEALTH databases, as well as on a review by Devanand et al4 of ECT complications occurring before the existence of these databases, we believe this report to be the first of its kind.