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KMID : 1201420220150020122
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Journal of Neurocritical Care
2022 Volume.15 No. 2 p.122 ~ p.125
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Management of propofol-related infusion syndrome and discussion of POLG mitochondrial mutation: a case report
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Nguyen Brian
Figueroa Stephen
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Abstract
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Background: Propofol-related infusion syndrome (PRIS) is a known complication of long-term propofol infusion. Providers should be aware of PRIS risk, as early recognition is key to avoiding mortality, which can range from 30% to 60%. The underlying mechanism of PRIS is unknown, but some studies suggest that underlying mitochondrial dysfunction may predispose patients to developing PRIS.
Case Report: We present a case of refractory adult-onset epilepsy that was challenging due to a paradoxical response to propofol with worsening brief ictal/interictal rhythmic discharges and complicated by development of PRIS. We aimed to discuss the clinical presentations of PRIS, along with a review of the mitochondrial POLG mutation found in our patient, which has also been described in other case reports of refractory adult-onset epilepsy.
Conclusion: We discuss the treatment strategy utilized in hopes of raising awareness of the risks in managing patients with epilepsy who have a potential underlying mitochondrial disorder.
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KEYWORD
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Epilepsy, Propofol infusion syndrome, Mitochondrial diseases, Mutation, Propofol, Adult
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