Utilization of Propofol as an Analgesic Adjuvant in the Multimodal Management of Acute Erythromelalgia Secondary to Lyme Disease Neuropathy: A Case Report

Pediatric neuropathic pain can be difficult to treat, may require a multimodal approach, and is often guided by adult literature given the paucity of pediatric studies. A healthy adolescent male presented with acute onset of severe bilateral lower extremity neuropathic pain diagnosed as erythromelalgia secondary to Lyme disease. After standard medication regimens failed to control his symptoms, popliteal nerve blocks improved pain control and subhypnotic doses of propofol provided significant pain relief. This case describes a complex multidisciplinary workup and multimodal treatment-including the successful use of subhypnotic propofol doses as an analgesic adjuvant for resistant pediatric neuropathic pain.