• Zahir Hussain
  • Masood A. Qureshi
  • K. Zaki Hasan
  • Hasan Aziz


Background: In view of considerable differences of opinion regarding the reproductive steroidhormonal pathogenesis in catamenial epilepsy, hormonal analysis of estrogen and progesterone incatamenial epileptics for a precise correlation is of significant importance. Methods: Clinical,neurological and physiological assessments, and radioimmunoassay of plasma estradiol-17b andprogesterone a day prior to the onset of menstruation were carried out in noncatamenial and mildcatamenial epileptics having multiple frequency tonic-clonic (primary and secondary generalized)seizures. Results: Highly significant rise (p > 0.0001) of estradiol-17b was obtained forcatamenial epileptics compared to normal subjects as well as noncatamenial epileptics (p > 0.02).However, nonsignificant fluctuations of progesterone were found for both catamenial andnoncatamenial epileptics against normal subjects as well as catamenial versus noncatamenialepileptics. Conclusions: The present report suggests that estradiol have a precise role in the mildpremenstrual exacerbation of seizures. However, no significant change in progesterone levelsmight have been due to mild exacerbation of seizures in these patients. Furthermore, we suggestthe importance of how we collect and categorize the data and which pathophysiologic process/clinicobiological mechanism is involved in patients with catamenial epilepsy. Contradictoryresults in literature may be related to differential levels of excitation/inhibition equilibrium duringvarious cycle phases. More precise studies including the determination of the blood levels ofantiepileptic drugs, however, are required.Key Words: Estradiol, progesterone, mild catamenial epilepsy


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