Generalized Clonic Jerks After Administration of Etomidate Before ECT-A Case Report

Out on PubMed, from clinicians in Spain, is this LTE:

Generalized Clonic Jerks After Administration of Etomidate Before ECT-A Case Report.

Lopez-Escribano R, Lacambra M, Asín A, Foguet-Boreu Q.J ECT. 2022 Dec 9. doi: 10.1097/YCT.0000000000000897. Online ahead of print.PMID: 36525389 

The LTE is here.
And here:

While this is a very interesting case report, I think there may be other ways to interpret what these clinicians encountered. First off, I am skeptical about the prior super high seizure threshold (ST)- I suspect the reason the seizure was short was that the stimulus was many times OVER the ST. Furthermore, it seems paradoxical that someone with such a high ST would be hyper-irritable with etomidate. The tracings in Figure 1 might well be artifact, IMO.
I wonder what would have happened if they had just continued with the ECT and assumed these were (somewhat more than) typical etomidate-induced myoclonic jerks.
I would love to hear other opinions from blog followers, please.



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