title: Epileptic seizure following IV tramadol in a patient with mental retardation and cerebellar ataxia.
abstract: OBJECTIVE
  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.
  
  
  BACKGROUND
  Tramadol is an analgesic with a dual mechanism of action and has several side effects, one of which is epileptic seizure.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Even in recommended doses, IV tramadol may cause epileptic seizures on predisposed patients.
authors.affiliation: Ministry of Health, Ankara Training and Research Hospital, II. Anesthesiology and Reanimation Clinic, Ankara, Turkey. haleuysal@gmail.com
authors.forename: Hale
authors.initials: H
authors.lastname: Yarkan Uysal
authors.forename: Bağnu
authors.initials: B
authors.lastname: Bilimgut
authors.forename: Bayazit
authors.initials: B
authors.lastname: Dikmen
authors.forename: Nurten
authors.initials: N
authors.lastname: Inan
authors.forename: Gülay
authors.initials: G
authors.lastname: Ulger
authors.forename: Solmaz
authors.initials: S
authors.lastname: Eruyar
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002524:Cerebellar Ataxia / Q000150:complications*; D004827:Epilepsy / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects*; D008607:Intellectual Disability / Q000150:complications*; D010149:Postoperative Pain / Q000188:drug therapy; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol