Métodos contraceptivos e epilepsia: considerações sobre a fisiopatogenia

Speciali, José Geraldo; Schelp, Arthur Oscar

doi:10.1590/S0004-282X1983000400002

Resumos

Os autores apresentam seis casos ilustrativos de pacientes em uso de métodos contraceptivos hormonais e DIU (dispositivo intrauterino). É feita também uma revisão crítica dos aspectos fisiopatogênicos. Os autores concluem que: 1 - Parece não haver dúvidas sobre a influência dos hormônios ovarianos na epilepsia. 2 - Não há previsibilidade quanto às conseqüências do uso de contraceptivos (hormonais e DIU) em pacientes com epilepsia catamenial. 3 - Há necessidade ainda de estudos complementares que elucidem melhor os fatores de risco na utilização de métodos contraceptivos pelas pacientes epilépticas.

The authors present six cases of patients with catamenial epilepsy, that use contraceptive methods (hormonal and intrauterin device). A critical report of the physiopathogenic aspects of hormones and epilepsy is also made. The authors conclude that: 1 - It seems there is no doubt about the influence of sexual hormones in epilepsy. 2 - There is no previsibility about the consequence of the use of contraceptives (hormonal and IUD) in patients with catamenial epilepsy. 3 - Further studies are still necessary to demonstrate the risk factors of contraceptive methods in epileptic patients.

Métodos contraceptivos e epilepsia: considerações sobre a fisiopatogenia

Contraceptive methods and epilepsy

José Geraldo Speciali^I; Arthur Oscar Schelp^II

^IProfessor Assistente Doutor. Departamento de Neuropsiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Preto

^IIMédico, Pós-Graduando em Neurologia. Departamento de Neuropsiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Preto

RESUMO

Os autores apresentam seis casos ilustrativos de pacientes em uso de métodos contraceptivos hormonais e DIU (dispositivo intrauterino). É feita também uma revisão crítica dos aspectos fisiopatogênicos. Os autores concluem que: 1 - Parece não haver dúvidas sobre a influência dos hormônios ovarianos na epilepsia. 2 - Não há previsibilidade quanto às conseqüências do uso de contraceptivos (hormonais e DIU) em pacientes com epilepsia catamenial. 3 - Há necessidade ainda de estudos complementares que elucidem melhor os fatores de risco na utilização de métodos contraceptivos pelas pacientes epilépticas.

SUMMARY

The authors present six cases of patients with catamenial epilepsy, that use contraceptive methods (hormonal and intrauterin device). A critical report of the physiopathogenic aspects of hormones and epilepsy is also made. The authors conclude that: 1 - It seems there is no doubt about the influence of sexual hormones in epilepsy. 2 - There is no previsibility about the consequence of the use of contraceptives (hormonal and IUD) in patients with catamenial epilepsy. 3 - Further studies are still necessary to demonstrate the risk factors of contraceptive methods in epileptic patients.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Trabalho do Departamento de Neuropsiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Preto, apresentado no X Congresso Brasileiro de Neurologia, outubro de 1982.

Departamento de Neuropsiquiatria e Psicologia Médica - Faculdade de Medicina - Caixa Postal 301- 14100 Ribeirão Preto, SP - Brasil.

1. BÄCKSTRÖM, T. - Epileptic seizures in women related to plasma estrogen and progesterone during the menstrual cycle. Acta neurol. scand. 54:321, 1976.
2. BALIN, H. - Oral contraceptives. Am. famil. Phys. 13:109, 1976.
3. BECK, W. W. - Complications and contraindications of oral contraception. Clin, obst. Gynecol., 24:893, 1981.
4. BICKERSTATT, E. R. - Neurological Complications of Oral Contraceptives Clarendon Press, Oxford, 1975, pg. 87-90.
5. CHICK, P. - Prescribing and oral contraceptive for the individual woman. Austr. famil. Phys. 9 (supl. 2):8, 1980.
6. COULAM, C. B. & ANNEGERS, J. F. - Do anticonvulsivants reduce the efficacy of oral contraceptives? Epilepsia 20:519, 1979.
7. CRAIG, C. R. - Anticonvulsivant activity of steroids: separability of anticonvulsivant from hormonal effects. Pharmacol, exp. Ther. 153:337, 1966.
8. CROSIGNANI, P. G. - Follow-up during oral contraception. J. endocrinol. Inv. 1:97, 1978.
9. DICKERSON, W. W. - The effect of menstruation on seizure incidence. J. nerv. ment. Dis. 94:160, 1941.
10. FAUNDES, A.; SEGAL, S. J.; ADEJUWON, C. A.; BRACHE, V.; LEON, P. & ALVAREZ-SANCHEZ, F. - The menstrual cycle in women using an intrauterine device. Fertil. Steril. 34:427, 1980.
11. FUXE, K.; HOKFELT, T. & NILSSON, O. - Castration, sex hormones and tubero infundibular dopamine neurons. Neuroendocrinol. 5:107, 1969.
12. GORDON, A. - Epilepsy in its relation to menstrual periods. A study of twenty-three cases. New York J. Med. 90:733, 1909.
13. GROFF, D. N. - Suggestion for control of epilepsy. New York J. Med. 62:3017, 1962.
14. HALL, S. M. - Treatment of menstrual epilepsy with a progesterone only oral contraceptive. Epilepsia 18:235, 1977.
15. JULIEN, R. M.; FOWLER, G. W. & DANIELSON, G. - The effects of anti-epileptic drugs on estrogen-induced electrographic spike-wave discharge. J. Pharmacol, exp. Ther. 193:647, 1975.
16. LAIDLAW, J. - Catamenial epilepsy. Lancet 271:1235, 1956.
17. LIN, T.; GREENBLATT, M. & SOLOMON, H. C. - A polygraphic study of one case of petit mal epilepsy: effects of medication and menstruation. Electroencephalogr. clin. Neurophysiol. 4:351, 1952.
18. LIVINGSTON, S. - Comprehensive Management of Epilepsy in Infancy, Childhood and Adolescence. C. C. Thomas, Springfield, 1972, pg. 101-102.
19. LOGOTHETIS, J.: HARNER, R.; MORREL, F. & TORRES, F. - The role of estrogens in catamenial exacerbation epilepsy. Neurology (Minneapolis) 9:352, 1959.
20. LONGO, L. P. S. & SALDARA, L. E. G. - Hormones and their influence in epilepsy. Acta neurol. lat. am. 12:29, 1966.
21. MARCUS, M. E.; WATSON, C. W. & GOLDMAN, P. L. - Effects of steroids on cerebral electrical activity. Arch. Neurol. (Chicago) 15:521, 1966.
22. MARQUES-ASSIS, L. - Influência da menstruação sobre as epilepsias. Arq. Neuro-Psiquiat. (São Paulo) 39:390, 1981.
23. NEWMARK, M. E. & PENRY, J. K. - Catamenial epilepsy: a review. Epilepsia 21:281, 1980.
24. PARDRIDGE, W. M. - Transport of nutrients and hormones through the blood-brain carrier. Diabetologia 20:246, 1981.
25. RICHARDSON, J.; MORRISON, J. ,& CHANG, A. - Epileptiform convulsions during inserction of intrauterine device. Lancet 2:148, 1977.
26. SCHELP, A. O. & SPECIALI, J. G. - Contribuição ao estudo clínico da epilepsia catamenial: tipos clínicos das crises convulsivas. Arq. Neuro-Psiquiat. (São Paulo) 41:152, 1983.
27. SPIEGEL, E. & WYCIS, H. - Anticonvulsive effects of steroids. J. Lab. clin. Med. 36:947, 1945.
28. STITT, S. L. & KINNARD, W. J. - The effect of certain progestius and estrogens on the threshold of electrically induced seizure patterns. Neurology (Minneapolis) 18:213, 1968.
29. TIMINAS, P. S. & HILL, H. F. - Hormones and epilepsy. In: Glaser, G. H.; Pairy, J. K. & Woodbury, P. M. (eds.) - Antiepileptic Drugs: Mechanisms of Action. Raven Press, New York, 1980.
30. TOIVAKKA, E. - Oral contraception in epileptics. Arzneim. Forsch. 17:1085, 1967.
31. WOOLLEY, D. E. & TIMINAS, P. S. - The gonad brain relationship: effects of female sex hormones on electroshock convulsions in the rat. Endocrinology 70:196, 1962.
32. ZIMMERMAN, A. W.; HOLDEN, K. R.; REITER, E. O. & DEKABAN, A. S. - Medroxyprogesterone acetate in the treatment of seizures associated with menstruation. J. Pediatr. 83:961, 1973.

Datas de Publicação

Publicação nesta coleção
14 Ago 2012
Data do Fascículo
Dez 1983

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

[1] 1. BÄCKSTRÖM, T. - Epileptic seizures in women related to plasma estrogen and progesterone during the menstrual cycle. Acta neurol. scand. 54:321, 1976.

[2] 2. BALIN, H. - Oral contraceptives. Am. famil. Phys. 13:109, 1976.

[3] 3. BECK, W. W. - Complications and contraindications of oral contraception. Clin, obst. Gynecol., 24:893, 1981.

[4] 4. BICKERSTATT, E. R. - Neurological Complications of Oral Contraceptives Clarendon Press, Oxford, 1975, pg. 87-90.

[5] 5. CHICK, P. - Prescribing and oral contraceptive for the individual woman. Austr. famil. Phys. 9 (supl. 2):8, 1980.

[6] 6. COULAM, C. B. & ANNEGERS, J. F. - Do anticonvulsivants reduce the efficacy of oral contraceptives? Epilepsia 20:519, 1979.

[7] 7. CRAIG, C. R. - Anticonvulsivant activity of steroids: separability of anticonvulsivant from hormonal effects. Pharmacol, exp. Ther. 153:337, 1966.

[8] 8. CROSIGNANI, P. G. - Follow-up during oral contraception. J. endocrinol. Inv. 1:97, 1978.

[9] 9. DICKERSON, W. W. - The effect of menstruation on seizure incidence. J. nerv. ment. Dis. 94:160, 1941.

[10] 10. FAUNDES, A.; SEGAL, S. J.; ADEJUWON, C. A.; BRACHE, V.; LEON, P. & ALVAREZ-SANCHEZ, F. - The menstrual cycle in women using an intrauterine device. Fertil. Steril. 34:427, 1980.

[11] 11. FUXE, K.; HOKFELT, T. & NILSSON, O. - Castration, sex hormones and tubero infundibular dopamine neurons. Neuroendocrinol. 5:107, 1969.

[12] 12. GORDON, A. - Epilepsy in its relation to menstrual periods. A study of twenty-three cases. New York J. Med. 90:733, 1909.

[13] 13. GROFF, D. N. - Suggestion for control of epilepsy. New York J. Med. 62:3017, 1962.

[14] 14. HALL, S. M. - Treatment of menstrual epilepsy with a progesterone only oral contraceptive. Epilepsia 18:235, 1977.

[15] 15. JULIEN, R. M.; FOWLER, G. W. & DANIELSON, G. - The effects of anti-epileptic drugs on estrogen-induced electrographic spike-wave discharge. J. Pharmacol, exp. Ther. 193:647, 1975.

[16] 16. LAIDLAW, J. - Catamenial epilepsy. Lancet 271:1235, 1956.

[17] 17. LIN, T.; GREENBLATT, M. & SOLOMON, H. C. - A polygraphic study of one case of petit mal epilepsy: effects of medication and menstruation. Electroencephalogr. clin. Neurophysiol. 4:351, 1952.

[18] 18. LIVINGSTON, S. - Comprehensive Management of Epilepsy in Infancy, Childhood and Adolescence. C. C. Thomas, Springfield, 1972, pg. 101-102.

[19] 19. LOGOTHETIS, J.: HARNER, R.; MORREL, F. & TORRES, F. - The role of estrogens in catamenial exacerbation epilepsy. Neurology (Minneapolis) 9:352, 1959.

[20] 20. LONGO, L. P. S. & SALDARA, L. E. G. - Hormones and their influence in epilepsy. Acta neurol. lat. am. 12:29, 1966.

[21] 21. MARCUS, M. E.; WATSON, C. W. & GOLDMAN, P. L. - Effects of steroids on cerebral electrical activity. Arch. Neurol. (Chicago) 15:521, 1966.

[22] 22. MARQUES-ASSIS, L. - Influência da menstruação sobre as epilepsias. Arq. Neuro-Psiquiat. (São Paulo) 39:390, 1981.

[23] 23. NEWMARK, M. E. & PENRY, J. K. - Catamenial epilepsy: a review. Epilepsia 21:281, 1980.

[24] 24. PARDRIDGE, W. M. - Transport of nutrients and hormones through the blood-brain carrier. Diabetologia 20:246, 1981.

[25] 25. RICHARDSON, J.; MORRISON, J. ,& CHANG, A. - Epileptiform convulsions during inserction of intrauterine device. Lancet 2:148, 1977.

[26] 26. SCHELP, A. O. & SPECIALI, J. G. - Contribuição ao estudo clínico da epilepsia catamenial: tipos clínicos das crises convulsivas. Arq. Neuro-Psiquiat. (São Paulo) 41:152, 1983.

[27] 27. SPIEGEL, E. & WYCIS, H. - Anticonvulsive effects of steroids. J. Lab. clin. Med. 36:947, 1945.

[28] 28. STITT, S. L. & KINNARD, W. J. - The effect of certain progestius and estrogens on the threshold of electrically induced seizure patterns. Neurology (Minneapolis) 18:213, 1968.

[29] 29. TIMINAS, P. S. & HILL, H. F. - Hormones and epilepsy. In: Glaser, G. H.; Pairy, J. K. & Woodbury, P. M. (eds.) - Antiepileptic Drugs: Mechanisms of Action. Raven Press, New York, 1980.

[30] 30. TOIVAKKA, E. - Oral contraception in epileptics. Arzneim. Forsch. 17:1085, 1967.

[31] 31. WOOLLEY, D. E. & TIMINAS, P. S. - The gonad brain relationship: effects of female sex hormones on electroshock convulsions in the rat. Endocrinology 70:196, 1962.

[32] 32. ZIMMERMAN, A. W.; HOLDEN, K. R.; REITER, E. O. & DEKABAN, A. S. - Medroxyprogesterone acetate in the treatment of seizures associated with menstruation. J. Pediatr. 83:961, 1973.