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Safety and Efficacy of Electroconvulsive Therapy in Myasthenia Gravis

Author(s): Tomasz Medrala, Karolina Drzyzga, Agnieszka Bratek, Krzysztof Kucia

Myasthenia Gravis is autoimmune disorder of neuromuscular transmission. In some cases, psychiatric complications aggravate its course. Myasthenia gravis (MG) has always been a challenge for anesthesiologists and psychiatrists when the use of electroconvulsive therapy (ECT) is required, especially when succinylcholine is used together with acetylcholinesterase inhibitors. We describe a 76 years old patient with treatment resistant major depressive disorder, without neurological symptoms of MG, under long-term acetylcholinesterase inhibitors treatment. ECT was administered in one successful, uneventful series of 7 treatments within 28 days with bilateral electrode placement. Although highest dosage of succinylcholine-1.5 mg/kg was used, the restart of breathing was without any problems after ECT sedation.

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