Somatic salvation in temporal lobe sclerosis: From resistance to remission with modified electroconvulsive therapy for dual neuropsychiatric symptom relief

Intractable seizure disorders present significant diagnostic and therapeutic challenges, particularly when an underlying autoimmune etiology is suspected. These seizures may be further complicated by co-occurring neuropsychiatric conditions, including organic mood disorders, which can exacerbate symptom severity, especially during periods of seizure clustering. Management becomes more complex when the patient demonstrates resistance or intolerance to multiple pharmacological agents, limiting conventional treatment options. A comprehensive, multidisciplinary approach is essential to ensure accurate diagnosis and individualized care in such scenarios. This case report highlights the clinical course of a patient with temporal lobe sclerosis who presented with intractable seizures and manic symptoms, both of which were unresponsive to standard pharmacotherapy. Modified electroconvulsive therapy (mECT) was employed as a somatic treatment modality, leading to significant improvement in both seizure control and mood stabilization. This case highlights the potential role of mECT not only in acute symptom resolution but also as a maintenance strategy in managing treatment-resistant neuropsychiatric conditions in consultation liaison psychiatry.