Refractory dystonia during propofol anaesthesia in a patient with torticollis-dystonia disorder.

PURPOSE: To report a case of refractory dystonia under propofol anaesthesia in a patient with Torticollis-Dystonia disorder.

CLINICAL FEATURES: A 38-yr-old man presented for an MRI scan for investigation of a Torticollis-Dystonia disorder. There was a biphasic response to propofol with complete amelioration of the torticollis and limb dystonia initially with subsequent recurrence under deep propofol anaesthesia. Coadministration of midazolam, diazepam, and thiopentone were not successful in abolishing the recurrent dystonia.

CONCLUSIONS

Propofol should preferably be avoided in patients with torticollis and dystonias. Where complete control of movements is required, it may be necessary to consider general endotracheal anaesthesia with muscle relaxants.