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Normeperidine-induced seizures in hereditary coproporphyria
1Department of Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44106.
Southern Medical Journal
|November 1, 1990
Summary
Seizures can occur during acute hepatic porphyria attacks. This case highlights normeperidine, a meperidine metabolite, as a cause of seizures in hereditary coproporphyria, suggesting meperidine is not ideal for pain management.
Area of Science:
- Neurology
- Metabolic Disorders
- Pharmacology
Background:
- Acute exacerbations of hepatic porphyria frequently present with seizures.
- The specific cause of seizures is often unidentified in these episodes.
- Hereditary coproporphyria is a type of acute hepatic porphyria.
Observation:
- A patient with hereditary coproporphyria experienced seizures during an acute attack.
- Meperidine is a commonly prescribed analgesic for pain management in porphyria patients.
- The patient's seizures were linked to normeperidine, a metabolite of meperidine.
Findings:
- This case report identifies normeperidine-induced seizures in a patient with hereditary coproporphyria.
- Meperidine, despite its common use, may not be a suitable analgesic for acute porphyria attacks.
- Normeperidine accumulation can precipitate seizures in susceptible individuals with porphyria.
Implications:
- Clinicians should consider meperidine and its metabolite normeperidine as potential triggers for seizures in porphyria.
- Alternative analgesics should be prioritized for pain control during acute porphyria exacerbations.
- Withdrawal of meperidine and targeted anticonvulsant therapy may effectively manage normeperidine-induced seizures in porphyria.