Período ovulatório e crises epilépticas

Guerreiro, Carlos A. M.

doi:10.1590/S0004-282X1991000200014

Resumos

Selecionamos 59 epilépticas crônicas, com crises em ciclos menstruais regulares. Conceituamos ciclos regulares, irregulares, período perimenstrual e ovulatório. Encontramos respectivamente 19, 30 e 6 pacientes com piora perimenstrual severa, moderada e leve, de acordo com nossos critérios. Da mesma forma, obtivemos 6, 20 e 17 pacientes com piora ovulatories severa, moderada e leve. Exceto descrições isoladas, não encontramos na literatura disponível trabalho que documente extensamente a piora das crises no período ovulatório. Discutimos os dados obtidos, assim como a possível explicação teórica. O efeito de drogas que modificam a ovulação nas crises epilépticas é revisto.

We prospectively follow up 80 mentally healthy women at menacme age, with chronic epilepsy and had had least one seizure in the month preceding the study. We selected 59 patients from whom we were able to observe at least three regular menstrual cycles with seizures. We defined regular, irregular cycle, perimenstrual and ovulation period. According to our concepts we have got 19, 30 and 6 patients with respectively severe, moderate and mild exacerbation of perimenstrual seizures. Using our definitions 6, 20 and 17 patients showed severe, moderate and mild accentuation of seizures during ovulation, while 15 patients showed no ovulatory accentuation. Our attention was drawn to the great number of perimenstrual and ovulatory exacerbation of seizures, according to our criteria. From 55 patients with perimenstrual accentuation of seizures 44 (74.54%) showed exacerbation during the ovulatory period. In our opinion, these data speak out in favor of the hormonal theory to explain these occurrences. We discuss these data based on the avaiable literature. We think the strogen peak is probably the main cause of the increased frequency of epileptic seizures during the ovulation period. New studies, documenting objectively the ovulation and seizures are mandatory to clarify the relationship of these aspects of the female endocrine reproductive physiology in epileptics.

CONTENTS CONTEÚDO

Carlos A. M. Guerreiro

Professor Assistente Doutor, Departamento de Neurologia, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP)

RESUMO

Selecionamos 59 epilépticas crônicas, com crises em ciclos menstruais regulares. Conceituamos ciclos regulares, irregulares, período perimenstrual e ovulatório. Encontramos respectivamente 19, 30 e 6 pacientes com piora perimenstrual severa, moderada e leve, de acordo com nossos critérios. Da mesma forma, obtivemos 6, 20 e 17 pacientes com piora ovulatories severa, moderada e leve. Exceto descrições isoladas, não encontramos na literatura disponível trabalho que documente extensamente a piora das crises no período ovulatório. Discutimos os dados obtidos, assim como a possível explicação teórica. O efeito de drogas que modificam a ovulação nas crises epilépticas é revisto.

SUMMARY

We prospectively follow up 80 mentally healthy women at menacme age, with chronic epilepsy and had had least one seizure in the month preceding the study. We selected 59 patients from whom we were able to observe at least three regular menstrual cycles with seizures. We defined regular, irregular cycle, perimenstrual and ovulation period. According to our concepts we have got 19, 30 and 6 patients with respectively severe, moderate and mild exacerbation of perimenstrual seizures. Using our definitions 6, 20 and 17 patients showed severe, moderate and mild accentuation of seizures during ovulation, while 15 patients showed no ovulatory accentuation. Our attention was drawn to the great number of perimenstrual and ovulatory exacerbation of seizures, according to our criteria. From 55 patients with perimenstrual accentuation of seizures 44 (74.54%) showed exacerbation during the ovulatory period. In our opinion, these data speak out in favor of the hormonal theory to explain these occurrences. We discuss these data based on the avaiable literature. We think the strogen peak is probably the main cause of the increased frequency of epileptic seizures during the ovulation period. New studies, documenting objectively the ovulation and seizures are mandatory to clarify the relationship of these aspects of the female endocrine reproductive physiology in epileptics.

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Dr. Carlos A. M. Guerreiro - Departamento de Neurologia, FCM/UNICAMP - Caixa Postal 6111 - 13081 Campinas SP - Brasil

1. Backstrom T. Epileptic seizures in women related to plasma estrogen and progesterone during the menstrual cycle. Acta Neurol Scand 1976, 54:321-347.
2. Backstrom T, Zetterlund B, Blom S, Romano M. Effects of intravenous progesterone infusions on the epileptic discharge frequency in women with parcial epilepsy; Acta Neurol Scand 1984, 69:240-248.
3. Dana-Haeri J, Richens A. Effect of norethisterone on seizures associated with menstruation Epilepsia 1983, 24:377-381.
4. Espir M, Walker ME, Lawson JP. Epilepsy and oral contraception 1969, 1:294-295.
5. Garcia CR, Rock J. Ovulation In Velardo JT (ed) : Essentials of Human Reproduction Clinical Aspects (Normal and Abnormal). New York: Oxford Univ Press 1958, p 22-54.
6. Gowers WR. Epilepsy and Other Chronic Convulsive Diseases: Their Causes Symptoms, and Treatment. New York: William Wood, 1885.
7. Guerreiro CAM, Ramos MC, Quagliato EMAB. Ciclo menstrual e crises-epilépticas. Rev Paul Med 1987, 105:72-74.
8. Helmchen H, Kunkel H, Selbach H. Periodishe Einflusse anf die individuale Hanfigkeit cerebral Anfalle. Arch Psychiat Nerkenkr 1964, 206:298-308.
9. Herzog, AG. Clomiphene therapy in epileptic women with menstrual disorders. Neurology 1988, 38:432-434.
10. Herzog AG, Seibel MM, Schomer DL, Vaitukattis JL, Geschwind N. Reproductive endrocrine disorders in women with partial seizures of temporal lobe origin. Arch Neurol 1986, 43:341-346.
11. Jensen I, Varnet K. Temporal lobe epilepsy: follow-up investigation of 74 temporal lobe resected patients. Acta Neurchir 1977, 37 : 173-200.
12. Laidlaw J. Catamenial epilepsy. Lancet 1956, 271:1235-1237.
13. Mattson RH. Overview of the interrelationship among seizures, hormones, and pregnancy. In Porter RJ, Mattson RH, Ward AA Jr, Adam M (eds): Advances in Epileptology (XVth. Epilesy International Symposium. New York: Raven Press 1984, p 197-199.
14. Mattson RH, Cramer JA, Caldwell BV, Siconolfi BC. Treatment of seizures with medroxyprogesterone acetate: preliminary report. Neurology 1984, 34:1255-1258.
15. Mattson RH, Kamer JA, Caldwell BV, Cramer JA. Seizure frequency and the menstrual cycle: a clinical study (Abstr). Epilepsia 1981, 23:242.
16. Millichap JG. Systemic electrolyte and neuroendocrine mechanisms. In Jasper HH, Ward AA Jr, Pope A (eds): Basic Mechanisms of the Epilepsies. Boston: Little Brown, 1969, p 709-726.
17. Newmark ME, Penry JK. Catamenial epilepsy: a review. Epilepsia 1980, 21:281-300.
18. Neugebauer R, Zybert P, O'Connor P, Hauser WA, Leppik IE, Berlin M, Bregstein J, Lavine J, Michalow M, Wicks J. Reliability and validity of patients daily seizure and event reports. In Porter RJ, Mattson RH, Ward AA Jr, Dam M (eds): Advances in Epileptology (XVth Epilepsy International Symposium) New York: Raven Press 1984, p 535-539.
19. Phelps D. Menstruation. In Velardo JT (ed): Essentials of Human Reproduction Clinical Aspects (Normal and Abnormal). New York, Oxford Univ Press 1958, p 55-87.
20. Rosciszewska D, Dudkiewioz J, Blacharz A. Changes in cytohormonal cervical swabs in epileptic women. Neurol Neurochir Pol 1976, 10:255-259.
21. Schnatz PT. Neuroendocrinology and the ovulation cycle: advances and review. Adv Psychosom Med 1985, 12:4-24.
22. Velardo JT. Endocrines and reproduction. In Velardo JT (ed): Essential of Human Reproduction Clinical Aspects, (Normal and Abnormal). New York: Oxford Univ Press 1958, p 3-31.

Período ovulatório e crises epilépticas

Ovulatory period and seizures.

Datas de Publicação

Publicação nesta coleção
22 Fev 2011
Data do Fascículo
Jun 1991

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Backstrom T. Epileptic seizures in women related to plasma estrogen and progesterone during the menstrual cycle. Acta Neurol Scand 1976, 54:321-347.

[2] 2. Backstrom T, Zetterlund B, Blom S, Romano M. Effects of intravenous progesterone infusions on the epileptic discharge frequency in women with parcial epilepsy; Acta Neurol Scand 1984, 69:240-248.

[3] 3. Dana-Haeri J, Richens A. Effect of norethisterone on seizures associated with menstruation Epilepsia 1983, 24:377-381.

[4] 4. Espir M, Walker ME, Lawson JP. Epilepsy and oral contraception 1969, 1:294-295.

[5] 5. Garcia CR, Rock J. Ovulation In Velardo JT (ed) : Essentials of Human Reproduction Clinical Aspects (Normal and Abnormal). New York: Oxford Univ Press 1958, p 22-54.

[6] 6. Gowers WR. Epilepsy and Other Chronic Convulsive Diseases: Their Causes Symptoms, and Treatment. New York: William Wood, 1885.

[7] 7. Guerreiro CAM, Ramos MC, Quagliato EMAB. Ciclo menstrual e crises-epilépticas. Rev Paul Med 1987, 105:72-74.

[8] 8. Helmchen H, Kunkel H, Selbach H. Periodishe Einflusse anf die individuale Hanfigkeit cerebral Anfalle. Arch Psychiat Nerkenkr 1964, 206:298-308.

[9] 9. Herzog, AG. Clomiphene therapy in epileptic women with menstrual disorders. Neurology 1988, 38:432-434.

[10] 10. Herzog AG, Seibel MM, Schomer DL, Vaitukattis JL, Geschwind N. Reproductive endrocrine disorders in women with partial seizures of temporal lobe origin. Arch Neurol 1986, 43:341-346.

[11] 11. Jensen I, Varnet K. Temporal lobe epilepsy: follow-up investigation of 74 temporal lobe resected patients. Acta Neurchir 1977, 37 : 173-200.

[12] 12. Laidlaw J. Catamenial epilepsy. Lancet 1956, 271:1235-1237.

[13] 13. Mattson RH. Overview of the interrelationship among seizures, hormones, and pregnancy. In Porter RJ, Mattson RH, Ward AA Jr, Adam M (eds): Advances in Epileptology (XVth. Epilesy International Symposium. New York: Raven Press 1984, p 197-199.

[14] 14. Mattson RH, Cramer JA, Caldwell BV, Siconolfi BC. Treatment of seizures with medroxyprogesterone acetate: preliminary report. Neurology 1984, 34:1255-1258.

[15] 15. Mattson RH, Kamer JA, Caldwell BV, Cramer JA. Seizure frequency and the menstrual cycle: a clinical study (Abstr). Epilepsia 1981, 23:242.

[16] 16. Millichap JG. Systemic electrolyte and neuroendocrine mechanisms. In Jasper HH, Ward AA Jr, Pope A (eds): Basic Mechanisms of the Epilepsies. Boston: Little Brown, 1969, p 709-726.

[17] 17. Newmark ME, Penry JK. Catamenial epilepsy: a review. Epilepsia 1980, 21:281-300.

[18] 18. Neugebauer R, Zybert P, O'Connor P, Hauser WA, Leppik IE, Berlin M, Bregstein J, Lavine J, Michalow M, Wicks J. Reliability and validity of patients daily seizure and event reports. In Porter RJ, Mattson RH, Ward AA Jr, Dam M (eds): Advances in Epileptology (XVth Epilepsy International Symposium) New York: Raven Press 1984, p 535-539.

[19] 19. Phelps D. Menstruation. In Velardo JT (ed): Essentials of Human Reproduction Clinical Aspects (Normal and Abnormal). New York, Oxford Univ Press 1958, p 55-87.

[20] 20. Rosciszewska D, Dudkiewioz J, Blacharz A. Changes in cytohormonal cervical swabs in epileptic women. Neurol Neurochir Pol 1976, 10:255-259.

[21] 21. Schnatz PT. Neuroendocrinology and the ovulation cycle: advances and review. Adv Psychosom Med 1985, 12:4-24.

[22] 22. Velardo JT. Endocrines and reproduction. In Velardo JT (ed): Essential of Human Reproduction Clinical Aspects, (Normal and Abnormal). New York: Oxford Univ Press 1958, p 3-31.