Kumar N, Behari M, Ahuja G K, Jailkhani B L
Department of Neurology, All India Institute of Medical Sciences, New Delhi.
Epilepsia. 1988 Mar-Apr;29(2):155-8. doi: 10.1111/j.1528-1157.1988.tb04412.x.
We studied the fluctuations in phenytoin (PHT) levels during ovulatory and menstrual phases of the cycle, in eight patients with catamenial epilepsy and in eight age-matched controls. Pharmacokinetic studies of PHT were done in five patients with catamenial epilepsy. The difference in PHT levels during menstrual and ovulatory phase in catamenial group was 3.44 +/- 3.25 micrograms/ml as compared with 0.91 +/- 2.03 micrograms/ml in controls. The mean fall during menstrual phase was significant (p less than 0.05) in the catamenial group. There was also rapid though statistically nonsignificant clearance of PHT during menses as compared with the ovulatory period. It is presumed that the fall in plasma PHT levels during menses, though still within therapeutic range, may be responsible for catamenial exacerbation of epilepsy.
我们对8例经期癫痫患者及8例年龄匹配的对照者在月经周期的排卵期和月经期苯妥英（PHT）水平的波动情况进行了研究。对5例经期癫痫患者进行了PHT的药代动力学研究。经期癫痫组月经周期中月经期与排卵期PHT水平的差异为3.44±3.25微克/毫升，而对照组为0.91±2.03微克/毫升。经期癫痫组月经期PHT水平的平均下降具有统计学意义（p<0.05）。与排卵期相比，月经期PHT的清除速度虽快但无统计学意义。据推测，月经期间血浆PHT水平的下降，尽管仍在治疗范围内，但可能是经期癫痫发作加剧的原因。
