激素疗法：孕酮。
Hormonal therapies: progesterone.
作者信息
Herzog Andrew G
机构信息
Harvard Neuroendocrine Unit, Beth Israel Deaconess Medical Center, Wellesley, Massachusetts 02481, USA.
出版信息
Neurotherapeutics. 2009 Apr;6(2):383-91. doi: 10.1016/j.nurt.2009.01.009.
Abstract
Seizures do not occur randomly in the majority of people with epilepsy. They tend to cluster. Seizure clusters, in turn, commonly occur with a temporal rhythmicity that shows a readily identifiable and predictable periodicity. When the periodicity of seizure exacerbation in women conforms to that of the menstrual cycle, it is commonly known as catamenial epilepsy. This may be attributable to 1) the neuroactive properties of steroid hormones and 2) the cyclic variation in their serum levels. If hormones play a role in seizure occurrence, hormones may also have a role in treatment. Progesterone has potent GABAergic metabolites that may provide safe and effective seizure control in women who have catamenial epilepsy.
摘要
在大多数癫痫患者中，癫痫发作并非随机发生。它们往往会成簇出现。反过来，癫痫发作簇通常会按照一种时间节律发生，这种节律显示出易于识别和预测的周期性。当女性癫痫发作加剧的周期与月经周期一致时，通常被称为经期癫痫。这可能归因于1）甾体激素的神经活性特性和2）其血清水平的周期性变化。如果激素在癫痫发作中起作用，那么激素在治疗中可能也发挥作用。孕酮具有强大的γ-氨基丁酸能代谢产物，这可能为患有经期癫痫的女性提供安全有效的癫痫控制。
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本文引用的文献
1
Circalunar and ultralunar periodicities in women with partial seizures.部分性癫痫女性的月周期和超月周期。
Epilepsia. 2008 Jun;49(6):1081-5. doi: 10.1111/j.1528-1167.2008.01537.x. Epub 2008 Feb 7.
2
Sensitivity and specificity of the association between catamenial seizure patterns and ovulation.经期癫痫发作模式与排卵之间关联的敏感性和特异性。
Neurology. 2008 Feb 5;70(6):486-7. doi: 10.1212/01.wnl.0000278102.55701.d0.
3
Differential effects of antiepileptic drugs on neuroactive steroids in men with epilepsy.抗癫痫药物对癫痫男性患者神经活性甾体的不同影响。
Epilepsia. 2006 Nov;47(11):1945-8. doi: 10.1111/j.1528-1167.2006.00826.x.
4
Hormone replacement therapy in women with epilepsy: a randomized, double-blind, placebo-controlled study.癫痫女性的激素替代疗法：一项随机、双盲、安慰剂对照研究。
Epilepsia. 2006 Sep;47(9):1447-51. doi: 10.1111/j.1528-1167.2006.00507.x.
5
The anticonvulsant effects of progesterone and its metabolites on amygdala-kindled seizures in male rats.孕酮及其代谢产物对雄性大鼠杏仁核点燃癫痫发作的抗惊厥作用。
Brain Res. 2006 Jul 26;1101(1):110-6. doi: 10.1016/j.brainres.2006.05.005. Epub 2006 Jun 19.
6
Ovarian cycle-linked changes in GABA(A) receptors mediating tonic inhibition alter seizure susceptibility and anxiety.介导紧张性抑制的γ-氨基丁酸A（GABA(A)）受体的卵巢周期相关变化会改变癫痫易感性和焦虑水平。
Nat Neurosci. 2005 Jun;8(6):797-804. doi: 10.1038/nn1469. Epub 2005 May 15.
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9
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J Pharmacol Exp Ther. 2004 Jul;310(1):230-9. doi: 10.1124/jpet.104.065268. Epub 2004 Feb 24.
10
Electrocortical activation by estrogens.
Arch Neurol. 1960 Sep;3:290-7. doi: 10.1001/archneur.1960.00450030068007.
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