Guerreiro C A
Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Brasil.
Arq Neuropsiquiatr. 1991 Jun;49(2):198-203. doi: 10.1590/s0004-282x1991000200014.
We prospectively follow up 80 mentally healthy women at menacme age, with chronic epilepsy and had had least one seizure in the month preceding the study. We selected 59 patients from whom we were able to observe at least three regular menstrual cycles with seizures. We defined regular, irregular cycle, perimenstrual and ovulation period. According to our concepts we have got 19, 30 and 6 patients with respectively severe, moderate and mild exacerbation of perimenstrual seizures. Using our definitions 6, 20 and 17 patients showed severe, moderate and mild accentuation of seizures during ovulation, while 15 patients showed no ovulatory accentuation. Our attention was drawn to the great number of perimenstrual and ovulatory exacerbation of seizures, according to our criteria. From 55 patients with perimenstrual accentuation of seizures 44 (74.54%) showed exacerbation during the ovulatory period. In our opinion, these data speak out in favor of the hormonal theory to explain these occurrences. We discuss these data based on the available literature. We think the estrogen peak is probably the main cause of the increased frequency of epileptic seizures during the ovulation period. New studies, documenting objectively the ovulation and seizures are mandatory to clarify the relationship of these aspects of the female endocrine reproductive physiology in epileptics.
我们前瞻性地随访了80名处于月经初潮年龄、患有慢性癫痫且在研究前一个月至少有一次发作的心理健康女性。我们从其中挑选出59名患者，能够观察到她们至少有三个伴有发作的规律月经周期。我们定义了规律周期、不规律周期、围经期和排卵期。根据我们的概念，分别有19名、30名和6名患者出现围经期发作的重度、中度和轻度加重。按照我们的定义，6名、20名和17名患者在排卵期出现发作的重度、中度和轻度加重，而15名患者未出现排卵期发作加重。根据我们的标准，癫痫发作在围经期和排卵期大量加重引起了我们的注意。在55名围经期癫痫发作加重的患者中，44名（74.54%）在排卵期出现发作加重。我们认为，这些数据支持用激素理论来解释这些现象。我们根据现有文献对这些数据进行了讨论。我们认为雌激素峰值可能是排卵期癫痫发作频率增加的主要原因。需要新的研究客观记录排卵和癫痫发作情况，以阐明癫痫患者女性内分泌生殖生理这些方面之间的关系。
