Brain MRI Findings in Tramadol Poisoning

Tramadol intoxication and its non-therapeutical abuse have recently become prevalent in Iran. Tramadol overdose cases may be complicated by some neurologic incidences such as seizure. In this study, we aimed to evaluate possible central neural system lesions in patients with tramadol-induced seizure using MRI imaging.
A cross-sectional study was conducted with age- and sex-matched case and control groups. The case group included oral tramadol intoxication cases with loss of consciousness and/or tramadol induced seizure. The control group included patients with seizure without tramadol consumption. The brain MRI was done in the first post-seizure 24-hour. Finally, all data were analyzed using SPSS software.
15 patients (7 females and 8 males) were in the control group and 15 patients (3 females and 12 males) were in the case group with mean age of 22.27±6.54 and 21.93±4.57 years, respectively. 8 patients of case group and 3 patients of control group had abnormal evidence (hyper signal foci in white matter) in brain MRI images; there was no significant difference between the two groups (P=0.128). Lesions depth in MRI images of the case group were equally in Subcortical and Deep parts of the white matter (37.5%) and in 2 cases (25%) were observed in both parts. There was no difference between the two groups in this regard (P=0.721).
In our study, over half of the case group patients had hypersignal but nonspecific evidence in MRI imaging. No significant difference was observed between case and control groups in the lesions pattern.