Jovanović-Cupić Vesna, Martinović Zarko, Nesić Nada
Institute on Addictions, Belgrade, Serbia and Montenegro.
Clin Toxicol (Phila). 2006;44(2):143-6. doi: 10.1080/1556365050014418.
To assess the frequency of seizures and patient characteristics associated with tramadol intoxication and abuse in young addicts.
Patients with history of tramadol abuse and intoxication were prospectively studied during a 3-year period. The characterstics of patients with seizures and those without seizures were compared.
Fifty-seven patients (mean age 22.3 years [range 16-43 years], 47 males) were included. Tonic/clonic seizures occurred in 31 (54.4%) patients, (26 males and 5 females): single in 14 (45%), multiple in 17 (55%) patients after a tramadol dose ranging from 250-2500 mg. Seizures occurred within 24 h after tramadol intoxication in 26 (84%) patients, and later in 5 (16%) patients. Compared to addicts without seizures, the abusers with seizures were younger (p < 0.05). Both epileptiform and nonepileptiform electroencephalographic patterns were more common in patients with seizures than in patients without seizures, but the differences did not reach statistical significance.
The neurotoxicity of tramadol commonly manifests as generalized tonic-clonic seizures occurring most frequently within 24 h after tramadol intake. Seizures were more common in younger abusers with a longer duration of exposure to tramadol and with the combined use of tramadol with alcohol.
评估年轻成瘾者中与曲马多中毒及滥用相关的癫痫发作频率和患者特征。
对有曲马多滥用和中毒病史的患者进行了为期3年的前瞻性研究。比较了有癫痫发作和无癫痫发作患者的特征。
纳入57例患者（平均年龄22.3岁[范围16 - 43岁]，47例男性）。31例（54.4%）患者出现强直/阵挛性发作，（26例男性和5例女性）：在服用250 - 2500 mg曲马多后，14例（45%）为单次发作，17例（55%）为多次发作。26例（84%）患者在曲马多中毒后24小时内出现癫痫发作，5例（16%）患者随后出现发作。与无癫痫发作的成瘾者相比，有癫痫发作的滥用者更年轻（p < 0.05）。癫痫样和非癫痫样脑电图模式在有癫痫发作的患者中比在无癫痫发作的患者中更常见，但差异未达到统计学意义。
曲马多的神经毒性通常表现为全身性强直 - 阵挛性发作，最常发生在服用曲马多后24小时内。癫痫发作在接触曲马多时间较长且同时使用曲马多和酒精的年轻滥用者中更常见。
