曲马多诱发癫痫发作：一项为期3年的研究。
Tramadol induced seizure: A 3-year study.
作者信息
Boostani Reza, Derakhshan Siavash
机构信息
Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran.
出版信息
Caspian J Intern Med. 2012 Summer;3(3):484-7.
BACKGROUND
Tramadol is a synthetic analgesic. Seizures have been reported in patients receiving this drug. In this study we evaluated the correlation between tramadol consumption and seizure occurrence.
METHODS
Twenty-eight subjects with a history of tramadol consumption and seizure were studied. Electroencephalograms (EEG) were performed in the first 24 hours and again one week later. Subjects were followed up for a mean of 18 months after the initial attack.
RESULTS
In the 28 subjects, 26 (92.8%) were males and 2 (7.2%) were females. The mean age of the subjects was 28.4 years. Thirteen patients had abused more than 400 mg/day of tramadol. Sixteen subjects concomitantly used other drugs. The seizures occurred within the first 24 hours of tramadol intake in 25 of the subjects. The first EEG was abnormal in 12 cases, but the second EEG was abnormal in only one case. Neuroimaging of only one subject displayed patchy white matter lesions.
CONCLUSION
In conclusion, the neurotoxicity of tramadol commonly manifests as generalized tonic clonic seizures most frequently within 24 hours after tramadol intake and was more common in subjects concomitantly consuming alcohol, illicit drugs, anti-psychotics, or anti-depressants.
背景
曲马多是一种合成镇痛药。已有接受该药物治疗的患者发生癫痫发作的报道。在本研究中，我们评估了曲马多使用与癫痫发作之间的相关性。
方法
对28例有曲马多使用史和癫痫发作史的受试者进行了研究。在最初24小时内及1周后再次进行脑电图（EEG）检查。在首次发作后，对受试者平均随访18个月。
结果
28例受试者中，男性26例（92.8%），女性2例（7.2%）。受试者的平均年龄为28.4岁。13例患者滥用曲马多的剂量超过每日400mg。16例受试者同时使用其他药物。25例受试者在服用曲马多的最初24小时内发生癫痫发作。首次脑电图检查有12例异常，但第二次脑电图检查仅有1例异常。仅1例受试者的神经影像学检查显示有斑片状白质病变。
结论
总之，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的24小时内，在同时饮酒、使用非法药物、抗精神病药物或抗抑郁药物的受试者中更为常见。
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