Epilepsy in women of reproductive age

Abstract

Four hundred fourty seven women with epilepsy aged 18–55 years were examineds, and catamenial epilepsy (CE) and/or reproductive dysfunction was diagnosed in 64 cases. Methods of investigation included clinical and neurological examination, routine EEG and/or video-EEG-monitoring, brain MRI, and laboratory tests. In the examined patients, antiepileptic drugs (AED) were prescribed for the first time or current therapy was corrected. CE was diagnosed in 30 cases: a perimenstrual form of CE was revealed in 24 cases, a luteal phase form in 5, and an ovulation form in one. Idiopathic generalized epilepsy (IGE) was diagnosed in 2 cases, temporal lobe epilepsy in 20, frontal epilepsy in 6, and non-localized focal epilepsy in 2. High frequency of seizures correlated with inefficacy of treatment (r = 0.3; p <0.05). Menstrual cycle (MC) dysfunction was diagnosed in 25 cases: dysmenorrhea in 21 and amenorrhea in 4. MC dysfunction was associated with excess weight in 44% of cases, and with ovarian cysts or polycystic ovary syndrome in 20%. After correction of the treatment, normalization of MC was achieved in 48% of cases. In this group, remission was observed in 57.1% of cases, improvement in 14.3%, and the lack of effect in 28.6%. Some correlations of the AED efficiency with positive dynamics of MC were shown.