ABSTRACT
Physiologic endocrine secretion during the menstrual cycle influences the occurrence of seizures. In ovulatory cycles, seizure frequency shows a statistically significant positive correlation with the serum estradiol/progesterone ratio. The premenstrual exacerbation of seizures has been attributed to the withdrawal of the antiseizure effects of progesterone. Reproductive dysfunction and endocrine disorders are unusually common among women who have partial epilepsy. Reproductive endocrine disorders, including polycystic ovarian syndrome and hypogonadotropic hypogonadism, as well as possibly premature menopause and functional hyperprolactinemia appear to be overrepresented among women with partial seizures of temporal lobe origin. Normalization of reproductive endocrine functions and menstrual cycles among women who have both partial seizures and menstrual disorders with documented inadequate luteal phase has been demonstrated to significantly and sometimes dramatically lessen seizure frequency. Improved seizure control has been related to normalization of the reproductive endocrine cycle but, as yet, has not been recognized as an approved indication for continued clomiphene use.
