Recurrent seizure activity after epidural morphine in a post-partum woman

Abstract

Our report indicates that even a remote history of epilepsy carries a pro-convulsant potential in the peripartum period, even following the administration of small doses of epidural morphine.

Presumed generalised seizure following caudal epidural administration of morphine and detomidine in a pony

“…Generalised seizures have been reported in people following high doses of intravenous morphine (Gregory et al, 1992). Generalised seizures have also been documented after epidural administration of morphine in patients with a history of epilepsy (Borgeat et al, 1988;Shih et al, 2005) and epidural morphine administration has been used to induce myoclonic activity in a rodent model (Shohami et al, 1986). Morphine-3-glucuronide (M3G), one of the main metabolites of morphine has been associated with neuroexcitation in rats (Hemstapat et al, 2009) and it has been suggested that high concentrations of M3G may be responsible for the CNS excitation associated with high-dose administration of morphine in horses (Knych et al, 2014).…”

“…1988; Shih et al . 2005), and epidural morphine administration has been used to induce myoclonic activity in a rodent model (Shohami et al . 1986).…”

Alcohol and drugs in epilepsy: Pathophysiology, presentation, possibilities, and prevention

“…Other opioids analgesics (codeine, dextropropoxyphene, meperidine, and oxycodone) and opioid anaesthetic agents (fentanyl, alfentanil, sufentanil, and morphine) may cause generalized seizures after a low to moderate dose (Saboory et al., 2007), but particularly after intrathecal use (Parkinson et al., 1990; Shih et al., 2005). Their ability to enhance epileptiform discharges can help in clinical localization; alfentanil appears the more potent activator (McGuire et al., 2003), although remifentanil has also been used (Grønlykke et al., 2008).…”