Abstract

TRAMADOL INDUCED PARTIAL SEIZURE: A RARE ADVERSE DRUG REACTION - CASE REPORT

*Dr. Bezawada Shravani, Dr. Anuradha H.V. and Dr. Shivamurthy M. C.

ABSTRACT

Tramadol is a synthetic codeine analogue, acts at μ-opioid receptors (MOR) receptor and used to treat moderate pain with its onset of action being 10-15 minutes to 1 hour and duration lasting upto 4-6 hrs. It inhibits uptake of norepinephrine and serotonin. It commonly causes vomiting, dry mouth sedation, very rarely seizures. Risk of seizure is more when used at high doses, abused for long time, used concomitantly with certain serotonergic or monoaminergic drugs and in patients with history of epilepsy. A 23 year young unmarried female patient diagnosed as a case of Acute Pancreatitis and Systemic lupus erythematosis complained of severe low back pain and was prescribed one dose of Inj. Tramadol 50mg intravenously. She developed jerky movements of the upper portion of her body involving the left arm and shoulder and uprolling of eye balls to one side after 10 min. This single episode lasted for about a minute and subsided thereafter immediately. Patient was conscious during the episode. No further such episodes noticed. No previous history of drug allergy or past and family history of seizures. No history of smoking, alcohol, drug abuse. No significant drug interactions were noted with inj. tramadol. This case illustrates that tramadol when used at low doses and without any predisposing risk factors as explained has the propensity to cause seizure. This reaction could be an idiosyncratic reaction. It alarms one to be more vigilant and monitor adverse reaction while prescribing various dose ranges of Tramadol.

Keywords: Tramadol, seizure, idiosyncratic reaction.