Successful ECT in a patient with hydrocephalus, shunt, hypopituitarism, and paraplegia.

A 25-year-old patient with paraplegia, hypopituitarism, hydrocephalus, and a ventriculoperitoneal shunt was successfully treated with a course of bilateral electroconvulsive therapy (ECT) for major depression. Brain imaging studies and neurology/ endocrinology consultations were obtained prior to the use of ECT. Throughout the course of ECT, his replacement hormonal therapy continued. Prior to each ECT, additional parenteral hydrocortisone was also administered. Consistent with the previously published reports, the patient did not experience any neurological deterioration. A brief review of the literature on the use of ECT in patients with panhypopituitarism, spinal cord injury, and hydrocephalus is presented.