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Very early-onset schizophrenia (VEOS) has a very rare prevalence, below 2 in one million children. Electroconvulsive therapy (ECT) is a controversial treatment modality that is only rarely performed on children and adolescents. There is a marked paucity of published data relating to the indications, use, clinical outcome and complications of ECT in this age group. We reported a case of ECT in 11-year-old female patient with VEOS who displayed auditory and visual hallucinations, disorganized speech and behavior, and psychomotor agitation. The patient received 19 modified bilateral ECT through intravenous general anesthesia because of the unresponsiveness to risperidone, olanzapine, seroquel and amisulpride. During ECT, she remained on only risperdal 2 mg/day. After 15 treatments, there was significant improvement in her psychotic features. After 19 treatments, her psychotic features disappeared and her social activity was much improved. ECT in the management of childhood schizophrenia could be an effective treatment option, especially at the failure of pharmacologic and psychotherapeutic treatment modalities.
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