Alireza Ghassemi Toussi - Addiction Research Center (ADRC), Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Background: One of the side effects of tramadol is seizure. Tramadol is a synthetic analgesic used to treat mild to moderate pain. Tramadol can cause seizures in the range of treatment and toxic doses. This seizure is usually in a generalized tonic-clonic from and usually occurs in the first 24 hours after ingestion. Case Presentation: The patient was a 32-year-old man referring to the emergency department with a right shoulder joint dislocation. It was reported that after a tonic-clonic seizure for about 1 minute, it has been followed by foaming at the mouth, eye lifting, urinary incontinence and loss of consciousness for about 5 minutes. He used a combination substance of sildenafil and tramadol to treat an early ejaculation. The patient has referred to the hospital 5 times with shoulder dislocation, without providing a detailed explanation about the use of tramadol and subsequent seizures Discussion: Tramadol misuse and overdose is a common medical issue in Iran and around the world. Regarding the arbitrary use of tramadol in Iran, especially through the non-scientific prescriptions by apothecaries in some cases such as early ejaculation treatment, attention to patient records along with the cause of referral is essential. Conclusion: Considering the prevalence of tramadol use, the community of physicians is advised to think of tramadol as a common cause for shoulder dislocation.

Ejaculation, Seizures, Shoulder dislocation, Tramadol