Nonconvulsive status epilepticus: the role of morphine and its antagonist

A 77-year-old woman with no history of epilepsy presented a probable noncon vulsive status epilepticus while receiving continuous intravenous morphine for back pain relating to vertebral metastasis of a malignant lymphoma. A g eneralized tonic-clonic seizure occurred a few minutes after injection of t he morphine antagonist naloxone. No cerebral lesion was detected. This obse rvation supports the notion of a possible pro-epileptogenic effect of opioi d substances in association with metabolic and other toxic factors. Various hypotheses as to the complex actions of morphine and its antagonist in epi leptogenesis are discussed. (C) 2000 Editions scientifiques et medicales El sevier SAS.