[Spontaneous seizures improve severe dementia conditions. Dementia contra depression-induced pseudodementia and electric stimulation therapy of depressed patients with epilepsy].

On the basis of two case reports, the differential diagnostic difficulties between pseudodementia conditioned by depression and genuine dementia are discussed and the particular conditions present in connection with electroconvulsive therapy (ECT) in patients with reduced seizure thresholds. Differentiation between genuine and dementia conditioned by depression must be made mainly on the basis of the clinical picture, particularly the temporal course of the condition. Every condition of dementia involves the possibility of an underlying depression and antidepressive treatment should be offered on wide indications. In this connection, ECT treatment may be the most effective and mildest form of therapy. Epilepsy does not counterindicate ECT treatment which, on the other hand, has an anticonvulsive effect. Occurrence of spontaneous seizures in connection with ECT treatment does not necessarily indicate withdrawal of treatment which may be continued provided certain prerequisites are observed.