Propofol: pro- or anticonvulsant?

The pro- or anticonvulsant properties of propofol remain a matter of controversy. Although numerous case reports describe the appearance of abnormal movements, posturing and seizure-like activity related to the use of propofol, systematic studies in both humans and animals strongly suggest that it possesses antiepileptic properties. Propofol consistently reduces the seizure duration during electroconvulsive therapy, its use has been successful in controlling refractory status epilepticus and in animals it offers a strong protection against lignocaine- or pentylene-tetrazol-induced epilepsy. The beneficial effects of propofol may be related to its uniform depressant action on the central nervous system, to a potentialization of GABA-mediated pre- and postsynaptic inhibition, and by decreasing the release of excitatory transmitters, glutamate and aspartate.