EFFECTS OF PROPOFOL SEDATION ON SEIZURES AND INTRACRANIALLY RECORDED EPILEPTIFORM ACTIVITY IN PATIENTS WITH PARTIAL EPILEPSY

Background: Case reports suggesting both pro- and anticonvulsant effec t(s) of propofol have been published in recent years, The effects of s edative doses of propofol on epileptiform activities in patients suffe ring from intractable partial epilepsy were systematically investigate d. Methods: Fourteen patients suffering from complex partial seizures were studied. Electroencephalogram (EEG) was recorded from intracrania l electrodes implanted in the hippocampi and temporal neocortex. Propo fol was given as a computer-controlled infusion in four steps to achie ve target plasma propofol concentrations of 0.3, 0.6, 0.9, and 1.2 mu g/ml. Each concentration was maintained for 30 min, and steady-state k inetics were confirmed by blood levels drawn at 10th and 30th min al e ach level. Between the 15th and 30th min of each concentration of prop ofol, EEG was analyzed for presence of electroencephalographic seizure activity and/or number of interictal spikes (IIS). Effects of propofo l on IIS frequency at different electrode sites were compared using a two-way repeated measures analysis of variance. A value of P < 0.05 wa s considered significant. Results: None of the patients developed a se izure during the 2 h of propofol infusion. No ''false spikes'' (spikes developing with propofol infusion in areas where no spikes were seen in baseline EEG) were seen. Although effects of propofol on IIS freque ncy were highly variable across patients and at different propofol dos es in the same patient, there was no statistically significant effect bf propofol on any electrode site with any of the doses studied. Concl usions: We were unable to demonstrate a significant change in epilepti form activity with sedative doses of propofol in patients suffering fr om complex partial epilepsy.