Patients with Tramadol Induced Seizures Presented to Mansoura University Emergency Hospital

EL-Mansoury, Adel; Ghanem, Ahmed N; M.D., AMGAD A. ZAGHLOUL, M.D.; NAHLA S.E. EL BAHNASAWY,; Shabka, Osama; Helmy, Manar

doi:10.21608/mjfmct.2016.47924

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this respect, patients with previous trauma to the brain, history of epilepsy or on drugs that lower seizure threshold like antipsychotic drugs appear to be prone to the proconvulsant effects of tramadol [15]. Other studies indicated an increased risk of tramadol-induced seizures by the concomitant administration of drugs of abuse such as opiates and cannabis [22] or alcohol [23].…”

Section: Discussionmentioning

confidence: 99%

“…Tramadol has a history of causing seizures, according to several case reports, but these usually occurred at high dosages of the drug, between 250 and 2500 mg [13,22,23], suggesting that the effect is dose-dependent. Contrarily, some studies revealed that tramadol users did not have a higher risk of seizures when compared to those taking other opioid or nonopioid analgesics [24] or when compared to those taking codeine [25].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Protection by Vitamin E Against Tramadol-Induced Proconvulsant Effects and Brain Damage in Pentylenetetrazole-Induced Status Epilepticus in Rats

Abdel-Salam

Sayed

Omara

et al. 2023

J. Neurol. Epidemiol.

View full text Add to dashboard Cite

We investigated the effect of the opioid analgesic tramadol on the development of epileptic seizures and neuronal injury and the possible modulatory effect of vitamin E (Vit E) in rats with pentylenetetrazole (PTZ)-induced status epilepticus. Rats received repeated intraperitoneal (i.p.) injections of PTZ till the development of status epilepticus and were pretreated once with tramadol (30, 60 or 90 mg/kg), vitamin E (Vit E, 70 mg/kg) or both tramadol (90 mg/kg) and Vit E (70 mg/kg) prior to starting PTZ injections. Seizure scores, the latency time and the PTZ dose for each group required to reach status epilepticus were determined and histopathological examination of the brain tissue was done. Results indicated that tramadol produced both anticonvulsant and proconvulsant effects. The anticonvulsant effects of tramadol were observed for facial twitching (stage 1), convulsive body waves (stage 2), and myoclonic jerks and rearing (stage 3) and turn over onto one side position (stage 4) that were significantly inhibited by tramadol. In contrast, tonic-clonic convulsions (stage 5) were significantly increased by 60 or 90 mg/kg of tramadol as compared to PTZ control group. The mean latency and PTZ threshold dose for status epilepticus were markedly decreased after tramadol. The administration of Vit E exerted beneficial effects in decreasing epilepsy scores and increasing both the latency time and threshold dose of PTZ for reaching status epilepticus. Meanwhile, rats treated with both tramadol and Vit E exhibited significant increase in tonic-clonic convulsions and markedly shortened latency time to reach status epilepticus compared to those treated with only Vit E. In cerebral cortex and hippocampus, PTZ resulted in apoptotic cells, darkly stained degenerated and vacuolated neurons and gliosis. These pathological changes increased after tramadol but were markedly reduced by Vit E treatment. Collectively, these results suggest that: (i) tramadol exerts both anticonvulsant and proconvulsant effects; (ii) tramadol shortened the latency time and decreased the threshold dose of PTZ for evoking status epilepticus; (iii) PTZ-induced seizures and brain damage can be inhibited by Vit E; (iv) tramadol at high doses interferes with the effect of Vit E in inhibiting tonic-clonic convulsions and in reducing brain damage.

show abstract

Section: Discussionmentioning

confidence: 99%