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Effect of Electroconvulsive Therapy on Intractable Pain

Effect of Electroconvulsive Therapy on Intractable Pain Abstract Relief of long-standing pain by electroshock therapy has been reported by several investigators.1-3 The present study evaluates the procedure as a therapeutic method. It further considers the painful state as a symbolic organization and offers a formulation of the means whereby agents, such as electroconvulsive therapy (ECT) and prefrontal lobotomy, which do not alter pain threshold significantly, may produce relief of pain. Material and Method of Study Ten patients with long-standing pain were treated with electric shock on the neurological ward of a general hospital. The location of the pain and the associated pathology are indicated as follows:Causalgic pain in the left hand in a diabetic patient coming on after an operation for stenosing tenosynovitisPain and weakness in the lower extremities associated with a bony spur of the cervical cord and arachnoiditis following surgeryOrbital pain following enucleation of an eye (two cases)Pain in the back, References 1. Delusional reduplication may be expressed in spatial, personal, and temporal aspects. In reduplication for place (reduplicative paramnesia), the patient states that there are two or more places of the same name, although only one actually exists. In reduplication for person, it is stated that a given person is also someone else. For example, the patient may say that the doctor is an insurance agent. Temporal reduplication, in its transient form the déjà vu phenomenon, refers to a statement that a contemporary event has also occurred in the past. Amnesia is defined as the statement that the patient does not remember a particular event, person, place, or period of time. 2. Pisetsky, J. E.: Disappearance of Painful Phantom Limbs After Electric Shock Treatment , Am. J. Psychiat. 102:599, 1946. 3. Hohman, L. B., and Wilkinson, W. E.: Pain Equivalents Treated with Electroshock , U. S. Armed Forces M. J. 7:1025, 1953. 4. Boyd, D. A., Jr.: Electroshock Therapy in Atypical Pain Syndromes , Journal-Lancet 76:22, 1956. 5. Weinstein, E. A.; Kahn, R. L.; Sugarman, L. A., and Linn, L.: The Diagnostic Use of Amobarbital Sodium in Brain Disease , Am. J. Psychiat. 109:889, 1953. 6. Kahn, R. L.; Fink, M., and Weinstein, E. A.: Relation of Amobarbital Test to Clinical Improvement in Electroshock , A. M. A. Arch. Neurol. & Psychiat. 76:23, 1956. 7. Weinstein, E. A., and Kahn, R. L.: Denial of Illness: Symbolic and Physiological Aspects , American Lecture Series No. 249, Springfield, Ill., Charles C Thomas, Publisher, 1955. 8. Dynes, J. B., and Poppen, J. L.: Lobotomy for Intractable Pain , J. A. M. A. 140:15, 1949. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology & Psychiatry American Medical Association

Effect of Electroconvulsive Therapy on Intractable Pain

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Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6886
DOI
10.1001/archneurpsyc.1959.02340130057005
Publisher site
See Article on Publisher Site

Abstract

Abstract Relief of long-standing pain by electroshock therapy has been reported by several investigators.1-3 The present study evaluates the procedure as a therapeutic method. It further considers the painful state as a symbolic organization and offers a formulation of the means whereby agents, such as electroconvulsive therapy (ECT) and prefrontal lobotomy, which do not alter pain threshold significantly, may produce relief of pain. Material and Method of Study Ten patients with long-standing pain were treated with electric shock on the neurological ward of a general hospital. The location of the pain and the associated pathology are indicated as follows:Causalgic pain in the left hand in a diabetic patient coming on after an operation for stenosing tenosynovitisPain and weakness in the lower extremities associated with a bony spur of the cervical cord and arachnoiditis following surgeryOrbital pain following enucleation of an eye (two cases)Pain in the back, References 1. Delusional reduplication may be expressed in spatial, personal, and temporal aspects. In reduplication for place (reduplicative paramnesia), the patient states that there are two or more places of the same name, although only one actually exists. In reduplication for person, it is stated that a given person is also someone else. For example, the patient may say that the doctor is an insurance agent. Temporal reduplication, in its transient form the déjà vu phenomenon, refers to a statement that a contemporary event has also occurred in the past. Amnesia is defined as the statement that the patient does not remember a particular event, person, place, or period of time. 2. Pisetsky, J. E.: Disappearance of Painful Phantom Limbs After Electric Shock Treatment , Am. J. Psychiat. 102:599, 1946. 3. Hohman, L. B., and Wilkinson, W. E.: Pain Equivalents Treated with Electroshock , U. S. Armed Forces M. J. 7:1025, 1953. 4. Boyd, D. A., Jr.: Electroshock Therapy in Atypical Pain Syndromes , Journal-Lancet 76:22, 1956. 5. Weinstein, E. A.; Kahn, R. L.; Sugarman, L. A., and Linn, L.: The Diagnostic Use of Amobarbital Sodium in Brain Disease , Am. J. Psychiat. 109:889, 1953. 6. Kahn, R. L.; Fink, M., and Weinstein, E. A.: Relation of Amobarbital Test to Clinical Improvement in Electroshock , A. M. A. Arch. Neurol. & Psychiat. 76:23, 1956. 7. Weinstein, E. A., and Kahn, R. L.: Denial of Illness: Symbolic and Physiological Aspects , American Lecture Series No. 249, Springfield, Ill., Charles C Thomas, Publisher, 1955. 8. Dynes, J. B., and Poppen, J. L.: Lobotomy for Intractable Pain , J. A. M. A. 140:15, 1949.

Journal

A.M.A. Archives of Neurology & PsychiatryAmerican Medical Association

Published: Jan 1, 1959

References