{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:05:20Z","timestamp":1780581920423,"version":"3.54.1"},"reference-count":19,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,12,23]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2020-239206","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T12:17:36Z","timestamp":1610972256000},"page":"e239206","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Hereditary pseudocholinesterase deficiency discovery after electroconvulsive therapy"],"prefix":"10.1136","volume":"14","author":[{"given":"Basant K","family":"Pradhan","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noud","family":"van Helmond","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludmil V","family":"Mitrev","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo A","family":"Andonakakis","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"key":"2025082803170736000_14.1.e239206.1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1213\/00000539-197701000-00019","article-title":"Correlation of plasma cholinesterase activity and duration of action of succinylcholine during pregnancy","volume":"56","author":"Blitt","year":"1977","journal-title":"Anesth Analg"},{"key":"2025082803170736000_14.1.e239206.2","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199377020-00027"},{"key":"2025082803170736000_14.1.e239206.3","first-page":"313","article-title":"Pseudocholinesterase deficiency: a comprehensive review of genetic, acquired, and drug influences","volume":"78","author":"Soliday","year":"2010","journal-title":"Aana J"},{"key":"2025082803170736000_14.1.e239206.4","unstructured":"Miller RD , Eriksson LI , Fleischer LA . Miller\u2019s Anesthesia. Saunders, 2014."},{"key":"2025082803170736000_14.1.e239206.5","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/ALN.0000000000001409","article-title":"Current status of neuromuscular reversal and monitoring: challenges and opportunities","volume":"126","author":"Brull","year":"2017","journal-title":"Anesthesiology"},{"key":"2025082803170736000_14.1.e239206.6","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/YCT.0000000000000210","article-title":"Anticonvulsant mechanisms of electroconvulsive therapy and relation to therapeutic efficacy","volume":"31","author":"Duthie","year":"2015","journal-title":"J Ect"},{"key":"2025082803170736000_14.1.e239206.7","doi-asserted-by":"publisher","DOI":"10.1126\/science.173.3992.161"},{"key":"2025082803170736000_14.1.e239206.8","doi-asserted-by":"publisher","DOI":"10.1126\/science.159.3811.202"},{"key":"2025082803170736000_14.1.e239206.9","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e318070c686"},{"key":"2025082803170736000_14.1.e239206.10","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/01.yct.0000167463.71704.52","article-title":"Customized anesthetic preservation of ictal threshold in electroconvulsive therapy: role of adjunctive remifentanil with etomidate","volume":"21","author":"Augoustides","year":"2005","journal-title":"J Ect"},{"key":"2025082803170736000_14.1.e239206.11","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1097\/YCT.0b013e318205e1d3","article-title":"Rocuronium antagonized by sugammadex for series of electroconvulsive therapy (ECT) in a patient with pseudocholinesterase deficiency","volume":"27","author":"Batistaki","year":"2011","journal-title":"J Ect"},{"key":"2025082803170736000_14.1.e239206.12","doi-asserted-by":"publisher","DOI":"10.1007\/BF03015165"},{"key":"2025082803170736000_14.1.e239206.13","first-page":"54","article-title":"Ect modified by Atracurium","volume":"3","author":"Hicks","year":"1987","journal-title":"Convuls Ther"},{"key":"2025082803170736000_14.1.e239206.14","first-page":"129","article-title":"Atypical cholinesterase and prolonged apnea during electroconvulsive therapy","volume":"7","author":"Kramer","year":"1991","journal-title":"Convuls Ther"},{"key":"2025082803170736000_14.1.e239206.15","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.psym.2011.01.029","article-title":"Pseudocholinesterase deficiency in an ECT patient: a case report","volume":"52","author":"Reti","year":"2011","journal-title":"Psychosomatics"},{"key":"2025082803170736000_14.1.e239206.16","first-page":"280","article-title":"Heterozygous atypical cholinesterase: management during ECT","volume":"8","author":"Riesenman","year":"1992","journal-title":"Convuls Ther"},{"key":"2025082803170736000_14.1.e239206.17","doi-asserted-by":"crossref","first-page":"312","DOI":"10.5350\/DAJPN2018310311","article-title":"Severe pseudocholinesterase deficiency and ECT: a case report","volume":"31","author":"Yildizhan","year":"2018","journal-title":"Dusunen Adam"},{"key":"2025082803170736000_14.1.e239206.18","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2147\/CEOR.S221308","article-title":"Impact of Sugammadex versus Neostigmine\/Glycopyrrolate on perioperative efficiency","volume":"12","author":"Deyhim","year":"2020","journal-title":"Clinicoecon Outcomes Res"},{"key":"2025082803170736000_14.1.e239206.19","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1097\/ALN.0000000000002946","article-title":"Effect of a cognitive aid on reducing Sugammadex use and associated costs: a time series analysis","volume":"131","author":"Drzymalski","year":"2019","journal-title":"Anesthesiology"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:17:14Z","timestamp":1756376234000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,18]]},"published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1136\/bcr-2020-239206"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239206","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}