AASCIT - Journal - All Issues

ISSN: 2375-3838

International Journal of Clinical Medicine Research

The Journal

Manuscript Information

Electroencephalogram and Brain CT-Scan Changes in Tramadol Associated Seizures

International Journal of Clinical Medicine Research
Vol.6 , No. 3, Publication Date: Jul. 23, 2019, Page: 23-27

134 Views Since July 23, 2019, 66 Downloads Since Jul. 23, 2019

Paper in PDF (226K)

Follow on

Authors

[1]	Abbas Aghabiklooei, Department of Legal Medicine & Toxicology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
[2]	Sedighe Sadat Erfani, Department of Legal Medicine & Toxicology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Objective: Drug-induced convulsions are the main causes of new-onset seizures and tramadol is one of the commonest drugs that can induced seizure. Methods: In a cross-sectional prospective survey, we assessed the predisposing factors, electroencephalogram (EEG) and brain computed tomography (CT) findings in tramadol-associated seizures cases. Results: of total of 126 drug-induced seizures, 26.2% were purely due to tramadol. Convulsion occurred after using a mean dose of 422 mg. Nearly 94% experienced only one single tonic-clonic convulsion. Brain CT scan was normal in all patients and non-epileptiform pattern were detected in eighty percent on EEG. Insomnia was the main risk factor related to convulsion. Conclusion: Although, head CT Scan has no rule in early treatment of drug induced seizure at ED, imaging is essential for rule out the concomitant trauma and other probable causes of new case of seizure even though in drug associated seizure.

Keywords

Tramadol, Seizure, Brain CT Scan, Electroencephalogram

Reference

[01]	Josef G. Thundiyil, Thomas E. Kearney and Kent R. Olson. Evolving epidemiology of drug-induced seizures reported to a poison control center system. Journal of medical toxicology, Vol 3, No 1, March 2007.
[02]	Clarot F, Proust B, Vaz E, Goullé JP. Tramadol-benzodiazepines and buprenorphine-benzodiazepines: two potentially fatal cocktails? J Clin Forensic Med. 2003 Jun; 10 (2): 125-6.
[03]	Mike McEvoy. Overdose of tramadol have been reported, which has led several states to reclassify it has a controlled substance. Tramadol (Ultram): Drug Whys, 20 June 2013.
[04]	Tashakori A, Afshari R. Tramadol overdose as a cause of serotonin syndrome: a case series. Clin Toxicol (Phila). 2010 May; 48 (4): 337-41.
[05]	Talaie H, Panahandeh R, Fayaznouri M, Asadi Z, Abdollahi M. Dose-independent occurrence of seizure with tramadol. J Med Toxicol. 2009 Jun; 5 (2): 63-7.
[06]	Mehrpour M. Intravenous tramadol-induced seizure: Two case reports. IJPT 2005: 4 (2): 146-147.
[07]	Shadnia S, Brent J, Mousavi-Fatemi K, Hafezi P, Soltaninejad K. Recurrent seizures in tramadol intoxication: implications for therapy based on 100 patients. Basic Clin Pharmacol Toxicol. 2012 Aug; 111 (2): 133-6.
[08]	Guerrini R, Belmonte A, Genton P. Antiepileptic drug-induced worsening of seizures in children. Epilepsia. 1998; 39 Suppl 3: 2-10.
[09]	Thundiyil JG, Kearney TE, Olson KR. Evolving epidemiology of drug-induced seizures reported to a Poison Control Center System. J Med Toxicol. 2007 Mar; 3 (1): 15-9.
[10]	Thundiyil JG, Rowley F, Papa L, Olson KR, Kearney TE. Risk factors for complications of drug-induced seizures. J Med Toxicol. 2011 Mar; 7 (1): 16-23.
[11]	Pesola GR, Avasarala J. Bupropion seizure proportion among new-onset generalized seizures and drug related seizures presenting to an emergency department. J Emerg Med. 2002 Apr; 22 (3): 235-9.
[12]	Reuther L, Pedersen ST, Rønn AM. [Drug-induced seizures]. Ugeskr Laeger. 2003 Mar 31; 165 (14): 1447-51.
[13]	Emamhadi M, Sanaei-Zadeh H, Nikniya M, Zamani N, Dart RC. Electrocardiographic manifestations of tramadol toxicity with special reference to their ability for prediction of seizures. Am J Emerg Med. 2012 Oct; 30 (8): 1481-5.
[14]	Jovanović-Cupić V, Martinović Z, Nesić N. Seizures associated with intoxication and abuse of tramadol. Clin Toxicol (Phila). 2006; 44 (2): 143-6.
[15]	Messing RO, Closson RG, Simon RP. Drug-induced seizures: a 10-year experience. Neurology. 1984 Dec; 34 (12): 1582-6.
[16]	Farajidana H, Hassanian-Moghaddam H, Zamani N, Sanaei-Zadeh H. Tramadol-induced seizures and trauma. Eur Rev Med Pharmacol Sci. 2012 Mar; 16 Suppl 1: 34-7.
[17]	Adams, Stephen M, Knowles, Paul D. Evaluation of a first seizure. American Family Physician. 2007, Vol. 75 Issue 9, P 1342-1347.6p.
[18]	Boostani R, Derakhshan S. Tramadol induced seizure: A 3-year study. Caspian J Med. 2012 Summer; 3 (3): 484-487.
[19]	Sanaei Tehrani M, Noori M, Shakiba M, Jalali AH. Brain CT-Scan Findings in Unconscious Patients after Poisoning. Int J Biomed Sci. 2011 March; 7 (1): 1-5.
[20]	Labate A, Newton MR, Vernon GM, Berkovic SF. Tramadol and new-onset seizures. Med J Aust. 2005 Jan 3; 182 (1): 42-3.
[21]	Boyd IW. Tramadol and seizures. Med J Aust. 2005 Jun; 182 (11): 595-6.
[22]	Ryan NM, Isbister GK. Tramadol overdose causes seizures and respiratory depression but serotonin toxicity appears unlikely. Clin Toxicol (Phila). 2015 Jul; 53 (6): 545-50.
[23]	Tagaddosinejad F, Mehrpour O, Afshari R, et al. Factors related to seizure in tramadol poisoning and its blood concentration. J Med Toxicol. 2011 Sep; 7 (3): 183-8.