Modified ECT lowers dental, skeletal fracture risk.MedTwitter
Andrade conducted the study because the risk of skeletal and dental fractures associated with ECT is"not commonly discussed."
The musculoskeletal and dental injuries are caused by stretching, twisting, compression, or direct injury. Particularly during the motor seizure, the"sudden jerk" associated with the tonic contraction of muscles as well as the repeated jerks associated with each clonic contraction can result in injuries, including skeletal and dental fractures.
Andrade reviewed prior research into the skeletal and dental risks of ECT. The infrequency of cases and ethical difficulties in conducting randomized clinical trials with such patients require reliance on anecdotal reports, he said.Population-based data showed that the a fracture risk with modified ECT of two events per 100,000 ECTs. However, the risk may be as low as 0.36 events per 100,000 ECTs if calculated only with recent data, Andrade noted.
Such patients include those with severe osteoporosis, metastatic bone disease, osteogenesis imperfecta, Ehlers-Danlos syndrome, Harrington rod implants, recent long bone fractures, multiple bone fractures, surgical repair of hip fracture, vertebroplasty, and maxillofacial repair. Moreover, because ECT is typically administered through repeated sessions, dental injuries may accumulate over the course of treatment.
"Because of wide interpersonal variation, a neurostimulator may need to be used to identify the ideal dose for an individual patient," he added.
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