Electric Shock Therapy in a Case of Myasthenia Gravis Complicated by a Schizophrenic Psychosis

Successful administration of electroconvulsive therapy in a patient with treatment-resistant schizophrenia and coexisting myasthenia gravis

“…Due to refractory symptoms, ECT under general anesthesia was considered, and the patient had significant reduction in hallucinations. One previous case report described a patient with MG with schizophrenia receiving up to 20 ECT sessions[3] and nine case reports with concomitant other psychiatric disorders. [2] Our report further adds to the existing literature and indicates that with due precautions, ECT can be safely administered in patients with comorbid MG.…”

“…[1] However, the presence of comorbid myasthenia gravis (MG) poses considerable challenge and concerns for administering anesthesia during ECT. [2] To the best of our knowledge, till date, there is only a solitary case reporting the use of ECT in schizophrenia with coexisting MG.[3] Hence, in this case report, we describe successful administration of modified ECT under anesthesia in a patient with treatment-resistant schizophrenia with MG.…”

A 36-Year-Old Man with Agitated Behavior, Psychosis

“…3 In 1950, Robert L. Williams and Maximilian Silbermann reported a case of a 20-year-old female patient with a diagnosis of MG for 8 years who developed symptoms of schizophrenia psychosis, which resolved with neostigmine and electric shock therapy. 4 In 1993, Musha et al reported psychosis in three patients with MG associated with thymoma and high serum titers of anti-acetylcholine receptor (AchR) antibody. They proposed a concept of paraneoplastic autoimmune neuropsychiatric syndrome.…”