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Case Reports
. 2021 Jan 18;14(1):e239206.
doi: 10.1136/bcr-2020-239206.

Hereditary pseudocholinesterase deficiency discovery after electroconvulsive therapy

Basant K Pradhan  1 , Noud van Helmond  2 , Ludmil V Mitrev  3 , Angelo A Andonakakis  3
Affiliations
Case Reports

Hereditary pseudocholinesterase deficiency discovery after electroconvulsive therapy

Basant K Pradhan et al. BMJ Case Rep. .

Abstract

Inherited pseudocholinesterase deficiency refers to an uncommon defect in the butyrylcholinesterase enzyme which can result in prolonged muscle paralysis due to delayed breakdown of choline ester paralytic anaesthetic agents. We describe a 25-year-old woman receiving electroconvulsive therapy (ECT) for treatment of depression in whom motor function did not recover adequately after administration of succinylcholine. Investigated post-ECT, she was found to have severe pseudocholinesterase deficiency. Implications of pseudocholinesterase deficiency for ECT treatment and anaesthetic strategies are discussed.

Keywords: anaesthesia; psychiatry.

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Conflict of interest statement

Competing interests: None declared.

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