Serret-Montoya Juana, Villasís-Keever Miguel Angel, Ríos-Zúñiga Sandra, Sánchez-Vaca Gerardo, Zurita-Cruz Jessie Nalley, Hernández-Cabezza Abigail
Clínica de Ginecología Pediátrica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México.
Rev Med Inst Mex Seguro Soc. 2014;52 Suppl 2:S114-9.
There are multiple adverse effects from anti-epileptic drugs, including menstrual irregularities such as amenorrhea, oligomenorrhea, gynecomastia, galactorrhea and polycystic ovary syndrome. In view of the paucity of information, the purpose of this study was to determine the frequency of menstrual disorders in female adolescents with epilepsy in a tertiary care pediatric hospital.
Female adolescents with epilepsy, older than 9 years and with more than 1 year with epilepsy were included. Initially, pubertal stage was identified. During 6 months, menstrual patterns were assessed. Among those with detected menstrual disorders, a hormonal profile and gynecological ultrasound were performed. Statistical analysis was descriptive.
24 patients with a median of 13 years of age; 40 % with overweight or obesity. Most received more than two anti-epileptic drugs. Sixteen patients (66.6 %) had one or more menstrual disorders: 10 had menorrhagia, 6 polymenorrhea, 6 dysmenorrhea, 4 opsomenorrhea; 4 had primary amenorrhea and 1 secondary amenorrhea. There were four patients with hyperprolactinemia and three with hypothyroidism. Evolution time and treatment of epilepsy, as well as the number of anti-epileptic drugs were higher among those with menstrual disorders.
The high frequency of menstrual disorders in female adolescents with epilepsy should be taken into account as part of the comprehensive treatment of these patients.
抗癫痫药物有多种不良反应，包括月经不调，如闭经、月经过少、男子女性型乳房、溢乳和多囊卵巢综合征。鉴于相关信息匮乏，本研究旨在确定一家三级护理儿童医院中癫痫女性青少年月经紊乱的发生率。
纳入年龄大于9岁且患癫痫超过1年的癫痫女性青少年。首先，确定青春期阶段。在6个月期间，评估月经模式。在检测到月经紊乱的患者中，进行激素水平检测和妇科超声检查。统计分析采用描述性方法。
24例患者，中位年龄13岁；40%超重或肥胖。大多数患者服用两种以上抗癫痫药物。16例患者（66.6%）有1种或多种月经紊乱：10例月经过多，6例月经频发，6例痛经，4例月经稀发；4例原发性闭经，1例继发性闭经。4例高催乳素血症患者，3例甲状腺功能减退患者。月经紊乱患者的癫痫病程和治疗情况以及抗癫痫药物数量更多。
癫痫女性青少年月经紊乱发生率较高，应作为这些患者综合治疗的一部分予以考虑。
