Catamenial epilepsy: Definition, prevalence pathophysiology and treatment
Catamenial epilepsy: Definition, prevalence pathophysiology and treatment
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DOI：
10.1016/j.seizure.2007.11.014
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发表时间：
2008-03-01
影响因子：
3
通讯作者：
Herzog, Andrew G.
中科院分区：
文献类型：
--
作者：
Herzog, Andrew G.
癫痫发作不是随机发生的。它们往往聚集在大多数患有癫痫的男性和女性身上。反过来，癫痫发作群又往往表现出周期性。当癫痫加重的周期与月经周期一致时，称为月经期。癫痫。生殖类固醇的神经活性及其血药浓度的周期性变化是重要的病理生理因素。近年来的研究证实，月经发作的加重至少存在三种类型：排卵周期中的围产期和排卵期，以及无排卵周期中的整个黄体期。为将癫痫加重归类为月经性癫痫提供了一个合理的数学基础。它确认了大约三分之一的女性患有月经性癫痫。如果癫痫发作时表现出激素敏感性，它们也可能对激素治疗有反应。据报道，在女性中使用周期天然孕酮补充剂、去甲孕酮和促性腺激素释放激素类似物以及在男性中使用睾酮加或不加芳香化酶抑制剂的开放标签试验取得了成功。前瞻性、随机化、安慰剂对照、双盲研究是有保证的，而且正在进行中。(C)2007年英国癫痫协会。爱思唯尔有限公司出版。保留所有权利。
Seizures do not occur randomly. They tend to cluster in the majority of men and women with epilepsy. Seizure clusters, in turn, often show a periodicity. When the periodicity of seizure exacerbation aligns itself with that of the menstrual cycle, it is designated as catamenial. epilepsy. The neuroactive properties of reproductive steroids and the cyclic variation in their serum concentrations are important pathophysiologic factors. Recent investigations have demonstrated and confirmed the existence of at [east three patterns of catamenial seizure exacerbation: perimenstrual and periovulatory in ovulatory cycles and entire luteal phase in anovulatory cycles. A rational mathematical basis for the categorization of seizure exacerbation as catamenial epilepsy has been developed. It identifies approximately one third of women as having catamenial epilepsy. If seizures show hormonal sensitivity in their occurrence, they may also respond to hormonal treatment. Successful open label trials using cyclic natural progesterone supplement, depomedroxyprogesterone and gonadotropin-releasing hormone analogues in women and using testosterone with or without aromatase inhibitor in men have been reported. Prospective, randomized, placebo-controlled, double-blind investigations are warranted and under way. (C) 2007 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.