Prolonged apnea during electroconvulsive therapy in monozygotic twins case reports 英文参考文献.docVIP

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Prolonged apnea during electroconvulsive therapy in monozygotic twins case reports 英文参考文献.doc

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Prolonged apnea during electroconvulsive therapy in monozygotic twins case reports 英文参考文献

ZavorotnyyandZwanzgerAnnalsofGeneralPsychiatry2011,10:30 /content/10/1/30 CASE REPORT OpenAccess Prolongedapneaduringelectroconvulsive therapyinmonozygotictwins:casereports MaximZavorotnyy*andPeterZwanzger Abstract Inthepresentwork,wereporttwocasesofmonozygotictwinswhodevelopedprolongedapneaduring electroconvulsivetherapy(ECT)asacomplicationofanesthesia.Inbothcases,prolongedactionofsuccinylcholine causedbyabutyrylcholinesterase(BCHE)deficiencywasconfirmedbymeansofthedibucainenumbertest.In bothcases,geneticanalysisusingthepolymerasechainreactionrevealedhaplotypecombinedAandKvariant mutationsoftheBCHEgene,bothintheheterozygousform.ThesedatashowthepotentialriskofBCHE deficiencyasacomplicationofanesthesiaduringECT,andinparticularunderlinethepossiblegeneticcontribution withinacomplexpathogeneticmodel. Introduction severemajordepressiveepisodes.Bothpatientsshowed Electroconvulsivetherapy(ECT)isconsideredtobethe prolongedapneaduringanesthesia. most powerful antidepressant intervention, and is thus recommendedforthetreatment ofsevere pharmacore- Casepresentation fractory majordepressive disorder(MDD)accordingto Patient 1 international guidelines. Moreover, ECTis usually well A55-year-old,marriedmaleclerkwasadmittedforECT tolerated and the potential risks are mainly limited to inDecember2006becauseofmedication-resistant psy- anesthesia[1].Withregardtomusclerelaxationduring choticdepressionaccordingtoDiagnosticandStatistical ECT, several reports of prolonged apnea due to the Manual of Mental Disorders, fourth edition (DSM-IV) extendedactionofdepolarizingneuromuscularblocking criteria.Afterantidepressantmedicationwastaperedoff, agentshavebeenpublishedoflate[2-5]. ECTwasdelivered three times aweek.Right unilateral Reductionofbutyrylcholinesterase(BCHE)activity,as (RUL)stimulationwasadministeredusingaThymatron firstdescribedbyGermanphysicianWKarow[6,7],can IV ECT apparatus (Somatics Inc., Lake Buff, IL, USA). be induced by several somatic diseas