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ELECTROCONVULSIVE therapy (ECT) is an appropriate clinical model to investigate blood flow during seizures. In this study cerebral blood flow velocity (CBFV) was measured during 40 ECTs in 10 patients by means of transcranial Doppler sonography. EEG was recorded continuously. Under general anesthesia, the pre-convulsive blood flow velocity (Vmean) decreased significantly. After ECT, we measured a dramatic increase in Vmeanwhich was significantly greater in the left MCA than in the right MCA. After termination of seizures, flow velocities returned to baseline levels. The striking increase in cerebral blood flow velocity reflects excessive cerebral metabolism during convulsive neuronal activation. The left hemisphere seems to be more sensitive to electrical stimuli as was indicated by its predominant augmentation of CBFVs.

Single voxel proton spectroscopy was used to study brain metabolism in idiopathic spasmodic torticollis. Peak metabolite ratios in long echo time (135 ms) spectra were evaluated in the basal ganglia of 16 patients (29‐65 years). Eight of them were untreated; the other eight were examined 4‐6 weeks after administration of botulinum toxin type A. As compared with 60 control spectra, patients showed a significant, therapy‐resistant decrease in N‐acetyl‐L‐aspartate (NAA)/choline (Cho). NAA/cre‐atine (Cr) and Cho/Cr were close to normal in the post‐treatment group but significantly reduced in untreated patients. This result is consistent with the hypothesis that striatal Cr is reversibly elevated in chronic muscle stimulation. The right and left stria‐tum were affected to the same extent.