REFLEX STUDIES IN ELECTROSHOCK TREATMENTS

Abstract

administration of extramural electroshock therapy, special attention was paid to the problem of reflex changes following treatments. Various investigators have repeatedly pointed out the frequent presence of tendon hyperrflexia, ankle clonus and a Babinski sign following electroshock convulsions. Kino1 alone noted frequent plantar areflexia for a short period before the appearance of the Babinski sign. We observed an unusually high incidence of plantar areflexia without a Babinski sign after such treatments. This finding is of considerable theoretic importance because it brings up the significant question whether the electroshock convulsion is physiologically identical with the epileptic seizure, since the latter is almost always followed by a Babinski sign. Five hundred treatments were administered to 79 patients between the ages of 25 and 58 years. The patients were examined before treatment, immediately after the induced convulsions and at short intervals thereafter. There were 59 patients with manic-depressive psychosis, 12 with schizophrenia, 4 with involutional melancholia and 1 with a reactive depression associated with psychoneurosis. Before treatment, normal plan¬ tar responses were encountered in 418 tests, poor plantar responses in 58 tests and a Babinski sign in 21 tests; in 3 instances the same patient showed a unilateral Rossolimo sign. Each patient showed transitory hyperreflexia in the lower limbs for one to two minutes immediately after treatment. In 90 per cent of the patients ankle clonus was present. A Rossolimo sign was never seen after a convulsion. The reflex changes were not always the same after each treatment. Kino stated that the same reflex changes recurred after each treatment, but some of our patients showed a Babinski sign after some treatments and plantar areflexia after others. F. S. had five treatments. After the second she showed a Babinski sign on the right side, whereas after the other four treatments plantar areflexia was present for eight to ten minutes. 1. Kino, F. F.: Reflex Studies on Electric Shock Procedure, Brain 66:152, 1943.