Safety and Efficacy of Electroconvulsive Therapy in Myasthenia Gravis

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