REPRODUCTIVE ENDOCRINE CONSIDERATIONS AND HORMONAL-THERAPY FOR WOMEN WITH EPILEPSY

被引:68
作者
HERZOG, AG
机构
[1] BETH ISRAEL HOSP, CHARLES A DANA RES INST, NEUROENDOCRINE UNIT, BOSTON, MA 02215 USA
[2] HARVARD UNIV, SCH MED, DEPT NEUROL, BOSTON, MA 02115 USA
关键词
EPILEPSY; HORMONES; REPRODUCTION; ENDOCRINE; MENSTRUAL CYCLE; FEMALE; ESTROGENS; ANTICONVULSANTS; DRUG-INDUCED ABNORMALITIES;
D O I
10.1111/j.1528-1157.1991.tb05889.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Animal experimental and human clinical investigations show that estrogens lower and progestins raise many seizure thresholds. In women, seizure frequency varies with the serum estradiol to progesterone ratio. The fluctuation of this ratio during the menstrual cycle is a major factor in catamenial epilepsy. A decline in serum antiseizure medication levels premenstrually may be another factor. Estradiol to progesterone ratios are elevated in anovulatory or inadequate luteal phase cycles. This may explain a propensity for seizure onset at the time of menarche and the exacerbation of seizures during the months or years leading up to menopause. It may also be an important factor in the association between reproductive endocrine disorders and epilepsy. Specifically, polycystic ovarian syndrome and hypogonadotropic hypogonadism are significantly overrepresented among women with epilepsy. Epilepsy may promote the development of these disorders. These disorders, in turn, are characterized by inadequate luteal phase cycles that may promote the development or occurrence of seizures. In the setting of catamenial epilepsy or reproductive endocrine disorders, progestins, such as natural progesterone and parenteral medroxyprogesterone, or antiestrogenic agents, such as clomiphene, constitute rational and effective adjuncts to therapy.
引用
收藏
页码:S27 / S33
页数:7
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