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Rocuronium as Muscle Relaxant for Electroconvulsive Therapy in a Patient With Adult-Onset Muscular Dystrophy

Bryson, Ethan O. MD*; Aloysi, Amy S. MD; Katz, Maya MD; Popeo, Dennis MD; Kellner, Charles H. MD

Journal of ECT:
doi: 10.1097/YCT.0b013e31821d3541
Online Articles

Abstract: Adult-onset muscular dystrophy is an inherited myopathy characterized by a variable degree of progressive muscle weakness and degeneration. Although not usually fatal, significant muscle weakness results in an up-regulation of acetylcholine receptors on the less responsive postjunctional muscles. The resulting profound potassium release when these receptors are stimulated by the depolarizing muscle relaxant succinylcholine can result in potentially fatal cardiac arrhythmias. We report a case of electroconvulsive therapy safely administered in a 61-year-old man with adult-onset muscular dystrophy requiring muscle relaxation with rocuronium.

Author Information

From the Departments of *Anesthesiology, †Psychiatry, and ‡Neurology, Mount Sinai School of Medicine, New York, NY.

Received for publication February 14, 2011; accepted March 15, 2011.

Reprints: Ethan O. Bryson, MD, Mount Sinai Hospital, Department of Anesthesiology, One Gustave L Levy Place, New York, NY 10029 (e-mail:

Support was provided solely from institutional and departmental sources.

The authors declare no conflict of interest.

© 2011 Lippincott Williams & Wilkins, Inc.