Mattson R H, Rebar R W
Department of Neurology, Yale University School of Medicine, New Haven, Connecticut.
Am J Obstet Gynecol. 1993 Jun;168(6 Pt 2):2027-32. doi: 10.1016/s0002-9378(12)90945-x.
Sex steroids in oral contraceptives exert several effects on the central nervous system and are therefore of concern when used by neurologically compromised women. In general, oral contraceptives do not aggravate epileptic seizures and are not contraindicated in cases of tension headache. Oral contraceptives can be used in cases of migraine without focal neurologic symptoms as long as headache symptoms do not worsen. Levels of sex steroids can be diminished through enzyme induction by antiepileptic drugs, giving rise to the possibility of contraceptive failure and exposure of the fetus to the teratogenic properties of antiseizure medications. Women with common migraine (without focal neurologic symptoms) who are taking oral contraceptives should be monitored for possible exacerbation of their symptoms. Women who do experience worsening of headache symptomatology when taking the pill should consider alternate means of contraception.
口服避孕药中的性类固醇对中枢神经系统有多种影响，因此，神经功能受损的女性使用时需引起关注。一般而言，口服避孕药不会加重癫痫发作，紧张性头痛患者使用也无禁忌。只要头痛症状不加重，无局灶性神经症状的偏头痛患者可以使用口服避孕药。抗癫痫药物可通过酶诱导作用降低性类固醇水平，从而导致避孕失败以及胎儿暴露于抗癫痫药物的致畸特性之下。正在服用口服避孕药的普通偏头痛（无局灶性神经症状）女性应监测症状是否可能加重。服用避孕药后确实出现头痛症状恶化的女性应考虑采用其他避孕方法。
