Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
Epileptic Disord. 2011 Mar;13(1):107-10. doi: 10.1684/epd.2011.0404.
Seizures or seizure-like phenomena which are mostly convulsive have been observed during the induction, maintenance and withdrawal phases of propofol administration. The nature and mechanism of this phenomenon are not well understood and several case reports on these phenomena have presented only indirect evidence. We report on a patient who was administered propofol in order to control status epilepticus with success. However, every attempt at propofol withdrawal was followed by convulsive seizure-like activity. Continuous EEG monitoring showed muscle artefacts without any ictal discharges. Based on this finding, the propofol treatment was withdrawn and the seizure-like activity eventually attenuated and resolved. We propose that seizure-like phenomena associated with propofol withdrawal may not be ictal in nature and should not lead to unnecessary resumption of propofol infusion without documentation of an epileptic origin by EEG.
在异丙酚给药的诱导、维持和停药阶段，观察到大多数为惊厥性的发作或类似发作的现象。这种现象的性质和机制尚不清楚，关于这些现象的少数病例报告仅提供了间接证据。我们报告了一例成功用异丙酚控制癫痫持续状态的患者。然而，每次试图停用异丙酚后，都会出现类似惊厥的抽搐活动。连续脑电图监测显示有肌肉伪影，但无发作性放电。基于这一发现，停止了异丙酚治疗，类似发作的活动最终减弱并消失。我们提出，与异丙酚停药相关的类似发作的现象可能不是发作性的，在没有脑电图记录到癫痫起源的情况下，不应该在没有明确癫痫病因的情况下，不恰当地重新开始异丙酚输注。
