Background

Tramadol intake related seizures have emerged as a common cause of seizures in Egypt affecting mainly young men.

Objective

This study aimed to determine the percentage of tramadol induced seizures, and to compare the clinical, neurophysiological, and radiological features of tramadol induced seizures group with idiopathic epilepsy group.

Methods

Two phases study; at first phase, data analysis for all Kasr-Alainy epilepsy clinic patients in Cairo during the period from January 2012 through June 2014, then at second phase a group of tramadol induced seizures’ patients were compared with a matching group of idiopathic epilepsy patients. Detailed history and examination, laboratory tests, electroencephalogram (EEG), Magnetic Resonance Imaging (MRI) of the brain, and Hamilton depression rating scale (HAM-D) were performed for both groups.

Results

Tramadol induced seizures represented 7% of all patients (103 out of 1480) and 12% of male patients. All cases were males. Occupational driving was the most common job. Seizures were generalized tonic clonic (GTCs) in 86%. Seventy-seven percent of tramadol induced seizures developed with toxic tramadol dose (>400 mg/day). Inter-ictal EEG was normal in most patients (87.5%). Depression and EEG abnormalities were significantly less than idiopathic epilepsy patients. MRI brain for both groups was normal.

Conclusion

Tramadol induced seizures represented 7% of cases. This deviates the attention to the problem of tramadol addiction in Egypt and raises our awareness of tramadol induced seizures.

中文翻译：

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埃及曲马多相关的癫痫发作：流行病学，临床和放射学研究。

背景

曲马多摄入相关的癫痫发作已成为埃及癫痫发作的常见原因，主要影响年轻人。

目的

本研究旨在确定曲马多诱发癫痫发作的百分比，并比较曲马多诱发癫痫发作组与特发性癫痫组的临床，神经生理和放射学特征。

方法

研究分为两个阶段；在第一阶段，对2012年1月至2014年6月期间开罗所有Kasr-Alainy癫痫门诊患者的数据进行分析，然后在第二阶段，将一组曲马多诱发癫痫发作的患者与相应的特发性癫痫患者进行比较。两组均进行了详细的病史和检查，实验室检查，脑电图（EEG），脑磁共振成像（MRI）和汉密尔顿抑郁量表（HAM-D）。

结果

曲马多引起的癫痫发作占所有患者的7％（1480名患者中的103名）和男性患者的12％。所有病例均为男性。职业驾驶是最常见的工作。癫痫发作为86％的全身性强直阵挛性（GTC）。77％的曲马多诱发的癫痫发作以毒性曲马多剂量（> 400 mg /天）发展。大多数患者的发作间脑电图正常（87.5％）。抑郁和脑电图异常明显少于特发性癫痫患者。两组的MRI脑均正常。

结论

曲马多引起的癫痫发作占病例的7％。这使人们对埃及的曲马多成瘾问题失去了关注，并提高了我们对曲马多诱发癫痫发作的认识。