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Anesthesiology/Atypical Psuedocholinesterace

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Question
Hi Dr. Levy,
My son has Atypical PD, Dyspraxia and Verbal Apraxia. I read that choline supplementation may help with dyspraxia/apraxia symptoms, but I'm not sure if he would be able to "metabolize" the choline efficiently. Would choline supplementation not be advised due to PD? Thanks for your time and expertise! Lisa

Answer
This is not my area of expertise but pseudocholinesterase deficiency (to my knowledge) has nothing to do with supplemental choline metabolism. Specifically, these patients cannot metabolize succinylcholine which we use to paralyze patients for surgery. Clearly he can metabolize acetylcholine (the normal neurotransmitter in the body). Succinylcholine has a different structure that mimics acetylcholine and when it binds to the receptors, the normal cholinesterase cannot metabolize it so pseudocholinesterase is used. In your son's case, he doesn't have enough of that so he would have a prolonged block. Whether supplemental choline would exacerbate this problem, I'm not sure but I don't think so. You should also check other family members for PD as it is genetic.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

Anesthesiology

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Ronald Levy, M.D.

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Associate Professor of Anesthesiology, University of Texas Medical Branch at Galveston. I am a board certified anesthesiologist who can answer all questions related to any type of Anesthesia with the exception of Pain Management.

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