Ovarian hormones, anticonvulsant drugs, and seizures during the menstrual cycle in women with epilepsy.

The excretion of three oestrogen fractions and progesterone metabolites in 64 female epileptic patients was determined during the menstrual cycle, and in 50 women of this sample serum phenytoin and phenobarbitone levels were measured. A significant decrease of both hormones in epileptic patients was found as compared to a control group. The variations in serum phenytoin levels were greater in females with so-called catamenial epilepsy with a marked fall of drug levels between days 27 and 28 corresponding with an increase of seizure frequency. The effect of progesterone deficit on seizure susceptibility before menstrual bleeding is discussed, and the need of serum anticonvulsant level determination during the premenstrual phase in epileptic women is suggested.

[Analysis of changes in the incidence of seizures in pregnant women with epilepsy]. / Analiza zmiany czestosci napadów podczas ciazy u 65 kobiet chorych na padaczke.

Sixty-five (41%) of 153 pregnant women with epilepsy were selected for analysis because the course of the disease changed in them during pregnancy. In 43 of these women (67%) the frequency of seizures decreased and in 21 cases the seizures disappeared completely. In 22 patients (33%) the frequency of seizures increased in pregnancy. An unfavourable influence of pregnancy was observed more frequently in patients with vourable influence of pregnancy was observed more frequently in patients with severe epilepsy with evidence of organic changes in the central nervous system and mental changes. The prognosis was better in women with less severe disease continuing anticonvulsant treatment.

[Fertility in the population of women with epilepsy]. / Rozrodczosc w populacji kobiet chorych na padaczke.

Retrospective inquiry investigations of 263 women with epilepsy at the age above 15 years demonstrated that the reproductive functions in these women were twice lower than in the general population of this region. The number of unmarried was 7% above that in the population, 25% of married epileptic women had no children, and most married women controlled the birth rate resorting frequently to artificial abortions. The index of perinatal mortality of the newborns, dead fetuses and early deaths) was over three times higher than in the population: 88.2 and 25.6 respctively. The risk of spontaneous abortion was 11.3%, the risk of stillbirth 3.9%, the risk of early neonatal death 4.6%. The risk of spontaneous abortion and early neonatal death was higher in the group of women taking anticonvulsants during pregnancy.