Electroconvulsive therapy in a cochlear implant patient.

OBJECTIVE

To report the first use of electroconvulsive therapy (ECT) in a patient with a cochlear implant (CI).

STUDY

DESIGN

Clinical Capsule Report.

SETTING

University hospital.

PATIENT: : A 17-year-old boy who underwent Nucleus 22 cochlear implantation in 1995 presented with delirious mania in 2009. Aggressive pharmacologic management was ineffective, and ECT was recommended due to the potentially lethal nature of his psychiatric illness.

INTERVENTIONS: After careful consideration by a multidisciplinary team, unilateral ECT on the side opposite the CI without removal of the device was recommended. Electroconvulsive therapy was performed on hospital Days 20 and 21. Integrity testing of the CI was performed on hospital Day 38.

MAIN OUTCOME MEASURES: Subjective and objective assessment of cochlear implant functioning and response to ECT.

RESULTS

Electroconvulsive therapy was well tolerated and contributed to alleviation of presenting symptoms. The patient used his CI without subjective degradation of performance. Integrity testing of the CI after ECT confirmed proper functioning of the device.

CONCLUSION

This is the first report of ECT in a patient with CI. Unilateral ECT was performed contralateral to the CI without subjective or objective decline in performance. This Clinical Report motivates further study regarding the use of ECT in CI patients.