RT Journal Article SR Electronic T1 Hereditary pseudocholinesterase deficiency discovery after electroconvulsive therapy JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e239206 DO 10.1136/bcr-2020-239206 VO 14 IS 1 A1 Basant K Pradhan A1 Noud van Helmond A1 Ludmil V Mitrev A1 Angelo A Andonakakis YR 2021 UL http://casereports.bmj.com/content/14/1/e239206.abstract 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.