Journal of Emergency Practice and Trauma

Hypoxic-ischemic encephalopathy in a young man due to tramadol overdose

Document Type : Case Report

Authors

Zahra Ataee
Bita Dadpour

Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

https://doi.org/10.34172/jept.2019.21
Abstract
Objective: Tramadol is a synthetic analgesic with two mechanisms. The opioid and non-opioid mechanisms are responsible for tramadol side effects. Non-opioid side effects of tramadol are due to the reuptake inhibitions of serotonin and norepinephrine. Some of the side effects include anaphylactoid reactions, CNS depression, hypoglycemia, hypotension, respiratory depression, seizures, and serotonin syndrome. Seizure may happen in therapeutic doses. If the frequency of tramadol seizures increases, ischemic brain injury and hypoxic-ischemic encephalopathy can be induced.
Case Report: We report a young man with a history of tramadol abuse that was admitted with status epilepticus in Imam Reza hospital in Mashhad, Iran. Due to his altered mental status, he was intubated and antiepileptic agents were prescribed. He was transferred to ICU. After regaining consciousness, he was extubated and with the prescription of rehabilitation support he was discharged.
Conclusion: Tramadol is a synthetic analgesic agent with less potential for dependence. It is important to mention that the overdose of this drug is common. This drug has two mechanisms. This paper reports a case that developed generalized tonic clonic seizures due to tramadol and hypoxic ischemic encephalopathy. With adequate treatment and supportive care, patient’s mental status improves and he/she can be discharged.

Keywords

Tramadol
Status epilepticus
Hypoxic ischemic encephalopathy
Antiepileptic
Subjects
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Journal of Emergency Practice and Trauma
Volume 6, Issue 2
July 2020
Pages 112-114

  • Receive Date 23 September 2019
  • Revise Date 25 November 2019
  • Accept Date 27 November 2019

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