I had an interesting case last week of a 15yo male presenting with headache and altered level of consciousness with combativeness. He had no fever, no trauma and no history of migraines although family history was positive for migraines. Workup, including drug screen and CT of head, was negative. In plans for admission and eval by peds neuro I did an LP with propofol sedation thinking about an article I had seen recently on propofol for migraines. Amazingly, the teen "woke up" and was perfectly normal post sedation. He was admitted for observation and peds neuro eval and was discharged with a diagnosis of complex migraine.
So, this raises a few questions.
Are you using propofol in the ED for migraines?
If so, first line or after traditional treatment failure?
What dose do you use?
Thanks for input!
Pamela S Murphy, MD
John C. Lincoln Deer Valley Hospital
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