Abbasi F, Krumholz A, Kittner S J, Langenberg P
Maryland Epilepsy Center, and the Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Epilepsia. 1999 Feb;40(2):205-10. doi: 10.1111/j.1528-1157.1999.tb02076.x.
Although important associations between epilepsy and women's hormonal phases are described, the relation of menopause to epilepsy has received little attention.
By using a structured interview, we studied menopausal women with epilepsy seen at the University of Maryland Epilepsy Center over a 1-year period from 1994 to 1995. We analyzed the characteristics and temporal relation of the seizures to menopause and compared the frequency and severity of the seizures with those in a similar group of premenopausal women.
We identified 61 menopausal women (46 who were postmenopausal and 15 perimenopausal) and compared them with 46 premenopausal women. No statistically significant differences were noted in either the frequency or the severity of seizures comparing all menopausal or only postmenopausal with premenopausal women. However, 12 (20%) of the 61 menopausal women noted that their seizures first began during or after menopause, with eight having no proven cause for their seizures. Many individual women described changes in their seizures with menopause. Among the 61 menopausal women, 49 had established epilepsy before the onset of menopause, and 20 (41%) reported worsening of their seizures with menopause, 13 (27%) noted improvement, and 16 (33%) described no changes. These observations were similar for peri- and postmenopausal women. Of the 15 menopausal women taking hormone replacement therapy, the six taking progestin were significantly less likely to report worsening of their seizures.
These findings support the view that hormonal influences are important in women with seizures. Although, in aggregate, menopausal (combined perimenopausal and postmenopausal) and postmenopausal women's seizures were similar in frequency and severity to those of other women, menopause was associated with changes in seizures for some women. Moreover, menopause may be a previously unrecognized factor for some new-onset seizures. The relations between menopause and epilepsy deserve to be more fully investigated.
尽管已有关于癫痫与女性激素周期之间重要关联的描述，但绝经与癫痫的关系却很少受到关注。
通过结构化访谈，我们研究了1994年至1995年期间在马里兰大学癫痫中心就诊的绝经女性癫痫患者。我们分析了癫痫发作的特征及其与绝经的时间关系，并将癫痫发作的频率和严重程度与一组类似的绝经前女性进行了比较。
我们确定了61名绝经女性（46名已绝经和15名围绝经期），并将她们与46名绝经前女性进行比较。在比较所有绝经女性或仅已绝经女性与绝经前女性的癫痫发作频率或严重程度时，未发现统计学上的显著差异。然而，61名绝经女性中有12名（20%）指出她们的癫痫发作首次始于绝经期间或之后，但其中8名癫痫发作的原因不明。许多女性个体描述了绝经后癫痫发作的变化。在61名绝经女性中，49名在绝经开始前就已确诊患有癫痫，其中20名（41%）报告绝经后癫痫发作恶化，13名（27%）指出有所改善，16名（33%）表示没有变化。围绝经期和绝经后女性的这些观察结果相似。在15名接受激素替代疗法的绝经女性中，6名服用孕激素的女性报告癫痫发作恶化的可能性显著降低。
这些发现支持了激素影响对癫痫女性很重要的观点。尽管总体而言，绝经（包括围绝经期和绝经后）女性和绝经后女性的癫痫发作频率和严重程度与其他女性相似，但绝经与部分女性的癫痫发作变化有关。此外，绝经可能是一些新发癫痫发作的一个此前未被认识到的因素。绝经与癫痫之间的关系值得更全面地研究。
