• Hale Yarkan Uysal, Bağnu Bilimgut, Bayazit Dikmen, Nurten Inan, Gülay Ulger, and Solmaz Eruyar.
• Ministry of Health, Ankara Training and Research Hospital, II. Anesthesiology and Reanimation Clinic, Ankara, Turkey. haleuysal@gmail.com
• Pain Med. 2011 May 1;12(5):833-6.

ObjectiveTo 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.BackgroundTramadol is an analgesic with a dual mechanism of action and has several side effects, one of which is epileptic seizure.Case ReportA 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.ConclusionEven in recommended doses, IV tramadol may cause epileptic seizures on predisposed patients.Wiley Periodicals, Inc.

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