Período ovulatório e crises epilépticas

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.

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.

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