Ministry of Health, Ankara Training and Research Hospital, II. Anesthesiology and Reanimation Clinic, Ankara, Turkey.
Pain Med. 2011 May;12(5):833-6. doi: 10.1111/j.1526-4637.2011.01079.x. Epub 2011 Apr 4.
To present a case of an epileptic seizure related to intravenous (IV) tramadol for pain control following a total abdominal hysterectomy operation on a patient with mental retardation and cerebellar ataxia.
Tramadol is an analgesic with a dual mechanism of action and has several side effects, one of which is epileptic seizure.
A 42-year-old female with mental retardation and cerebellar ataxia presented with an epileptic seizure after administration of IV tramadol for postoperative pain. Magnetic resonance imaging scans were normal, but laboratory tests showed hypocalcemia. Next, calcium replacement was administered. Postoperative pain treatment with tramadol was discontinued because tramadol was felt to be a possible cause of the seizure observed in this patient. In order to treat the epileptic seizure, IV phenytoin sodium infusion was started. On the second postoperative day, calcium levels were found to be normal, and the IV antiepileptic medication was changed to an oral form. The patient had no subsequent seizures during the clinical follow-up. She was discharged on the fourth postoperative day without any other complications.
Even in recommended doses, IV tramadol may cause epileptic seizures on predisposed patients.
介绍一例癫痫发作的病例，该患者为智力障碍和小脑共济失调患者，在全子宫切除术后静脉注射曲马多（一种具有双重作用机制的镇痛药）控制疼痛时发生癫痫发作。
曲马多是一种具有双重作用机制的镇痛药，有多种副作用，其中之一是癫痫发作。
一名 42 岁女性，智力障碍和小脑共济失调，在接受静脉注射曲马多治疗术后疼痛后出现癫痫发作。磁共振成像扫描正常，但实验室检查显示低钙血症。随后给予钙补充。由于曲马多可能是导致该患者观察到的癫痫发作的原因，因此停用曲马多进行术后疼痛治疗。为了治疗癫痫发作，开始静脉注射苯妥英钠。术后第 2 天，血钙水平正常，将静脉抗癫痫药物改为口服。在临床随访期间，患者无后续癫痫发作。她在术后第 4 天无其他并发症出院。
即使在推荐剂量下，静脉注射曲马多也可能导致易感患者发生癫痫发作。
