AGGRESSIVE BEHAVIOUR AFTER SEVERE ACQUIRED BRAIN INJURY: SUCCESSFUL TREATMENT WITH ELECTRICAL AVERSION THERAPY: A CASE STUDY

Introduction: Aggression is a severe and frequent behavioral consequence of brain injury. Pharmacological interventions are used, though evidence of efficacy is lacking. Behavioral therapies have shown some effect. Electrical aversion therapy (EAT) is a behavioral therapeutic option that might be suitable for brain-injured individuals for whom other therapies are not effective.

The effect of EAT on aggression after brain injury has not been investigated previously.

Case Presentation: Here we report on a single case observational study on the effect of EAT on aggression in a 41-year old male with severe brain injury due to subarachnoid hemorrhage. Restraints, time out of bed, number of staff needed for care and aggressive behavior were measured.

The level of care and the number of restraints were markedly reduced with EAT, without incidents leading to injury to the patient or nursing staff. There was a trend towards decline in the frequency of aggressive behavior over time.

Discussion: The study design was observational but by comparing the first and the second part of the registration period we were able to demonstrate a decline in aggressive behavior after EAT. The large number of measurements was a strong aspect. The lack of control is however a major limitation.

Conclusion: We conclude that EAT was effective in this patient with aggressive behavior due to severe brain injury. EAT can therefore be considered in therapy resistant aggression in brain-injured patients.