Neurobiology of Sleep-Wakefulness Cycle 2(1): 27-32, 2002
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© 2002 NSWC
Accepted in revised form 20 March 2002; recieved 7 February 2002.
Introduction: Reproductive-endocrine disorders (RED) are distributed more often among women with epilepsy than in population. In patients with epilepsy and RED epilepsy is more often characterized by catamenial seizures in comparison with women without RED. It is thought that epilepsy manifested in puberty in one third of cases develop as catamenial seizures. Aim: To study distribution of RED and catamenial seizures among women with epilepsy manifested at menarche. Methods: 43 women with epilepsy manifested at menarche and with age range 12 -34 years were chosen (23 with cryptogenic partial and 20 with idiopathic generalized epilepsy). Interrelation between seizure exacerbation and phases of menstrual cycle (MC) was investigated during four months. By means of investigation of hypothalamic-gonadal hormones and suprapubic ultrasound two groups of the patients were defined: women with epilepsy (WWE - 19 cases) and women with coexisting epilepsy and RED (ERED group - 24 patients). 13 patients were antiepileptic drug (AED) free. Results: Catamenial exacerbation of seizures was shown in 46.5% of patients and was 3 times more often among patients of ERED group than of WWE group (66.7% vs 21%). MC disturbances 3.5 times more often prevailed in patients with RED (p>0.001). RED was almost equally distributed among treated and AED free groups (56.7% and 53.8%, p>0.05); RED was more often found among patients who were on valproate (VPA) therapy (p>0.2). Conclusions: The risk of RED development is high among the patients with epilepsy manifested at menarche and it does not depend on AED treatment as RED distribution was equally found in both treated and AED free groups. In women with epilepsy manifested at menarche and with catamenial course of seizures from the beginning may indicate on RED existence and could be served as an indicator of RED development.
Key Words: women, epilepsy, menarche, reproductive, endocrine disorders.
Correspondence: Kasradze Sofia, MD.,
DEpilepsy Center of Sarajishvili Institute of Neurology and Neurosurgery
2a Gudamakari str., Tbilisi, Georgia, 380092