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June 3, 1939

TRAUMATIC COMPLICATIONS OF CONVULSIVE SHOCK THERAPY: METHOD OF PREVENTING FRACTURES OF THE SPINE AND LOWER EXTREMITIES

Author Affiliations

OMAHA

From the departments of orthopedics and neuropsychiatry of the University of Nebraska College of Medicine and the Bishop Clarkson Memorial Hospital.

JAMA. 1939;112(22):2244-2246. doi:10.1001/jama.1939.02800220010003
Abstract

Convulsive shock therapy has been employed for several years in the treatment of severe psychoses without sufficient attention being paid to undesirable complications.1 We are reporting seven cases of spontaneous fractures which have occurred during the convulsions induced by metrazol (pentamethylenetetrazol). We shall also suggest a procedure for preventing most of these catastrophes.

Lehndorff1a was the first to report fractures resulting from the severe muscular contractions associated with tetanus. Later Sonntag2 reported fractures of the elbow and dislocations of the shoulder, Baisch3 discussed fractures of the femoral neck and Wilhelm4 described fractures of the forearm. All these fractures occurred during tonic convulsive seizures of tetanus. Roberg5 made a comprehensive study of the spinal changes and concluded that the forces exerted by tetanic muscular contractions produced compression fractures of the midthoracic vertebral bodies, usually those of the fifth and sixth vertebrae, in definite contrast to

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