Q. Can a high acetylcholinesterase level cause fasciculations, cramps, excess sweating, and watery eyes?

Answered by
Dr. Hitesh Kumar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 24, 2021

Hello doctor,

I am a 57-year-old male with a height of 180 cm and a weight of 88 kgs. Can a high acetylcholinesterase level in the blood cause fasciculations, cramps, excess sweating, sometimes watery eyes, muscle weakness, or atrophy? The above symptoms started approximately three years ago and have progressively got worse, mainly just affecting the left leg (atrophy or weakness). On my last blood test, it was noted that the acetylcholinesterase level was high and recommended for investigation due to my symptoms above. My general practitioner believes the symptoms mentioned are due to this and may have to be treated with an inhibitor in order to lower the acetylcholinesterase level. My question is, what is your opinion of the acetylcholinesterase level of 12174 U/L, and do you think this level could be the cause of the symptoms mentioned?



Welcome to

Mild to a moderately high level of acetylcholinesterase can be found in many conditions such as thyrotoxicosis, schizophrenia, hypertension, acute emotional disorders after a concussion injury. Markedly elevated levels can be found in nephrotic syndrome and through genetic. Similarly, fasciculations can be found in many conditions such as anxiety state, thyrotoxicosis, benign fasciculation syndrome, cramp fasciculation syndrome, motor neuron disease, and nerve injury and denervation. Your cholinesterase level just marginally high (very near to normal upper range). There may be some association between fasciculation or cramps and high acetylcholinesterase level, but it should not cause atrophy and weakness of one leg. It seems unlikely that this level is causing all such symptoms. I would like to know the history of the detailed symptoms about you in a sequential manner and also would like to see your other reports or neurologist assessment sheet for better understanding and further judgment.

Regarding follow up:

Revert with detailed clinical history in a sequential manner and other reports (send us an attachment).

Thank you doctor,

So your opinion is that the acetylcholinesterase at 12174 U/L levels is acceptable, not serious, and does not need to be inhibited from lowering it?



Welcome back to

All your symptoms are not fully explainable by this level of cholinesterase. Though you have not told your symptoms and findings in detail, you only mentioned fasciculation and progressive weakness and atrophy of the left leg. Possibly you need to consult a neurologist physically for detailed evaluation and assessment about your symptoms and may need further evaluation to make a diagnosis.

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