Propofol Use for Toxin-Related Seizures

The use of propofol as treatment of toxin-induced seizures is unclear. The goal of this study was to characterize the use of propofol for toxin-related seizures as reported to a statewide poison system.

This study was a retrospective review of the electronic records from a poison control system from 2009 to 2012. Inclusion criteria were patient age (≥ 18 yrs) and cases coded with "seizure" that contained the term "propofol." The age, sex, reported toxin(s) involved, recurrence of seizure activity following/during propofol use, and mortality were extracted.

Records review identified 235 poisoning cases, all of which involved adjunctive therapy with propofol. The age range was 18-82 years (53% female). A total of 155 different toxins were identified. Recurrent seizures occurred in 15.7% (n=37) of cases following propofol administration. The mortality rate was 6.8% (n=16) in cases with known outcomes.

Propofol is being used as an anticonvulsant in poisoned patients and appears to have some utility as an adjunct in terminating toxin-related seizures once airway control has been established. Less clear, however, is at what point propofol therapy should be initiated. Prospective controlled studies are warranted to identify the role of propofol in controlling toxin-induced seizures.