Hormonal considerations in women with seizures
S. C. Schachter
Department of Neurology, Harvard Medical School, MA 02215.
The relationships between seizures in epileptic women and the hormones
estrogen and progesterone are under increasing study. Serum concentrations
of estrogen and progesterone parallel cerebrospinal concentrations, and
circulating sex hormones are concentrated in specific areas of the brain
that regulate sexual behavior. These centers include two potentially
epileptogenic regions--the amygdala and hippocampus. Many of these
structures are physiologically affected in vitro by estrogen and
progesterone. Exogenous sex hormones change the seizure threshold in animal
models of epilepsy. Cyclical hormonal variations may influence
electroencephalographic activity and affect seizure frequency in women with
epilepsy. Hormonal therapy may be appropriate adjunctive anticonvulsant
treatment, particularly for women with seizures that are catamenial or
associated with a menstrual or reproductive endocrine disorder.
