Propofol-induced dyskinesias in Parkinson's disease

Spontaneous involuntary movements have been reported with the use of propofol, a parenteral anesthetic, in patients who had no prior history of movement disorders [1-4]. These movements were described as dystonic, choreoathetoid, or myoclonic. In patients with Parkinson's disease, propofol may temporarily suppress tremor [5]. We describe two patients with Parkinson's disease who underwent a stereotactic pallidotomy while off levodopa medication. In both patients, temporary sedation with propofol induced dyskinesias, which occurred in the same distribution and were phenomenologically similar to the levodopa-induced dyskinesias that these patients experienced. Possible antiparkinsonian and dyskinesia-inducing mechanisms of propofol are discussed.