<p></p><p>An&nbsp;analgesic&nbsp;or&nbsp;painkiller&nbsp;is any member of the group of&nbsp;drugs&nbsp;used to achieve analgesia, relief from&nbsp;pain. Analgesic drugs act in various ways on the&nbsp;peripheral&nbsp;and&nbsp;central&nbsp;nervous systems. They are distinct from&nbsp;anesthetics, which temporarily affect, and in some instances completely eliminate,&nbsp;sensation.</p><p>Analgesics include acetaminophen, the&nbsp;nonsteroidal anti-inflammatory drugs&nbsp;(NSAIDs) such as the&nbsp;salicylates, and&nbsp;opioid&nbsp;drugs such as&nbsp;morphine&nbsp;and&nbsp;oxycodone. They can be highly addictive. Oxycontin, as seen below, was once a widely prescribed drug, but due to the opioid epidemic in America, it has become more regulated.</p><p style="text-align: center; "><img src="@@PLUGINFILE@@/Oxycontin.jpg" alt="Oxycontin" width="420" height="237"></p><p>o&nbsp;&nbsp;&nbsp;Tramadol (yellow and green pills below) is an opiate analgesic – one of the weaker opiate analgesics, it is used to treat moderate to moderate-severe pain.</p><p style="text-align: center; "><img src="@@PLUGINFILE@@/tramadol.jpg" alt="tramadol" width="300" height="225" class="img-responsive atto_image_button_text-bottom"></p><h1><a name="_Toc14686155">Opioids</a></h1><p>Opioids include tramadol, oxycodone, morphine, &nbsp;codeine,&nbsp;hydrocodone,&nbsp;dihydromorphine, and pethidine.&nbsp;&nbsp;These medications are known for their addictive properties. Tramadol is an opioid that acts as an SNRI, which occupies a serotonin transporter in the thalamus. This drug can produce a spike wave discharge (giving rise to seizure), however, the more common findings are less remarkable: greater alpha synchrony and somewhat heightened beta amplitudes.</p><p>Effects include:</p><p></p><ul><li>Slowing in the delta range</li><li>&nbsp;Greater alpha synchrony</li><li>Higher amplitde beta</li><li>&nbsp; Burst suppression pattern in neonates</li><li>&nbsp;Enhancement of epileptiform activity</li></ul><p></p><p><br></p><p>&nbsp;The below data is a patient with addiction to pain killers, namely tramadol, oxycontin, and hydrocodone.</p><h3><a name="_Toc14686156">The 5 – 6Hz rhythm we see prominent at O2 and T6&nbsp; is a paroxysmal transient that occurs when the patient has closed eyes</a>, opiate addict.</h3><p style="text-align: center; "><img src="@@PLUGINFILE@@/5-6hz.png" alt="5-6Hz" width="500" height="732" class="img-responsive atto_image_button_text-bottom"><br></p><p></p><p><br></p><p></p><h5></h5><h3>The slow content that gives rise to seizure activity in an opiate addict is seen quantified here.</h3><br><h5 style="text-align: center; "><img src="@@PLUGINFILE@@/Slow%20Content.png" alt="Slow Content" width="600" height="383" class="img-responsive atto_image_button_text-bottom"><br></h5><h5><p>The figure below shows a fast spindling beta
frequency. This is a kindling frequency, which means that it is this fast
spindling frequency that ultimately leads to the slow transient discharge that
is ultimately the problem. In this case, the spindling beta represents an
irritable cortex—one that is easily “kindled,” meaning that it easily sets off
an epileptic event.</p></h5><h3><br>This fast spindling beta is a sign of an easily kindled cortex, which gives rise to epileptiform content (opioid addict)</h3><p></p><p><br>

</p><p></p><p style="text-align: center; "><img src="@@PLUGINFILE@@/beta%20spindles.png" alt="Beta Spindlse" width="600" height="957" class="img-responsive atto_image_button_text-bottom"></p><p><br></p><h3>Image of high amplitude spindling beta in an opiate addict</h3><p style="text-align: center; ">&nbsp;<img src="@@PLUGINFILE@@/map.png" alt="map" width="600" height="377" class="img-responsive atto_image_button_text-bottom"></p><p>The two figures above show a fast spindling beta frequency. This is a kindling frequency, which means that it is this fast spindling frequency that ultimately leads to the slow transient discharge that is ultimately the problem. In this case, the spindling beta represents an irritable cortex—one that is easily “kindled,” meaning that it easily sets off an event.</p><p><br>

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