PT - JOURNAL ARTICLE AU - Basant K Pradhan AU - Noud van Helmond AU - Ludmil V Mitrev AU - Angelo A Andonakakis TI - Hereditary pseudocholinesterase deficiency discovery after electroconvulsive therapy AID - 10.1136/bcr-2020-239206 DP - 2021 Jan 01 TA - BMJ Case Reports PG - e239206 VI - 14 IP - 1 4099 - http://casereports.bmj.com/content/14/1/e239206.short 4100 - http://casereports.bmj.com/content/14/1/e239206.full SO - BMJ Case Reports2021 Jan 01; 14 AB - 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.