Prolonged myoclonus and meningism following propofol

The purpose of this report is to describe a new complication of propofol administration. A previously fit patient underwent intravenous anaesthesia with propofol for removal of dental wires. Postoperatively he developed myoclonic jerking of his limbs. On regaining consciousness he complained of an occipital headache, neck stiffness and photophobia, and was found to have nuchal rigidity on examination. These clinical features resolved over the following week. Subsequent investigations failed to explain the aetiology of the symptoms of meningeal irritation, which suggests that propofol was the causative agent. While prolonged myoclonus has been previously described with propofol administration, this is the first report of meningism occurring with its use.