2002 issue 2

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Volume 11, issue 2

Review papers

Speciticity of epilepsy in women

Danuta Rościszewska1
1. Klinika Neurologii i Epileptologii Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Postępy Psychiatrii i Neurologii, 2002, 11, 117-123
Keywords: epilepsy, hormones, catamenial epilepsy, pregnancy, menopause
Abstract

The aim of the paper is to review the effect of gonadal and adrenal hormones on seizures in different physiological stages in lifetime of women with epilepsy. Studies in a variety of animal models of epilepsy support clinical observations that estradiol is generally proconvulsant, while progesterone is anticonvulsant. Women with epilepsy are more likely to experience abnormalities in their menstrual cycle length. Significantly abnormal cycles affect 18% of women with epilepsy. Irregular cycles may be a consequence of anovulatory menstrual cycles and/or luteal phase defficiency. Anovulatory cycles were reported to affect over 30% of menstrual cycles in a group of women with localization-related epilepsy of mesial temporal lobe origin. Irregular menstrual cycles and anovulation may also occur in association with polycystic ovaries. Although the frequency of polycystic ovaries occurrence in healthy women has not been established, several reports suggest that women with epilepsy are more likely to develop multiple ovarian cysts and to present a clinical picture similar to that of the polycystic ovary syndrome. In women with catamenial epilepsy the onset of seizures is often associated with menarche. In a small number of women the first ever seizure occurs during pregnancy. The effect of menopause on epilepsy is an area that has received scant attention. Pilot data suggest that synthetic hormone replacement therapy may be associated with an increase in the seizure frequency in menopausal women with epilepsy. Reproductive dysfunction has an important effect on the patients' overall health and quality of life.

Address for correspondence:
Adres: Dr Joanna Jędrzejczak, Klinika Neurologii i Epileptologii Centrum Medycznego Kształcenia Podyplomowego,
ul. Czerniakowska 231, 00-416 Warszawa