Meperidine Induced Seizure in a Patient With Lyme Borreliosis

A 15 years old child with Lyme borreliosis was treated with meperidine via a patient controlled analgesia (PCA) pump for pain management. He had no history of seizure and had normal hepatic and renal functions. At the 7th hour of meperidine PCA delivery, generalized tonic-clonic seizure was developed and successfully suppressed with antiepileptics and no neurologic sequel was occurred. The total meperidine consumption in the patient was quite lower than the recommended doses with PCA. Although Lyme disease might also cause seizure activities, the timing of the seizures was related with the accumulation of normeperidine which is the main metabolite of meperidine with central nervous system stimulant effect. The meperidine pain management on patients with Lyme syndrome should be reconsidered to avoid undesired effects. Keywords