月经周期对妇女癫痫发作的影响

The influence of menstrual cycle on epileptic seizures in women

目的探讨月经周期对癫痫妇女发作的影响。方法选择2010年1月至2015年12月武汉市汉口医院神经内科收治的354例女性癫痫患者,记录其连续3个月经周期的癫痫发作情况及生理特征,对发作频率与月经周期的关系进行分析,根据是否围月经期分为观察组与对照组,以45例围月经期癫痫患者作为观察组,以309例非月经期癫痫患者作为对照组,测定比较两组患者血清激素的变化情况。结果所有患者共记录到1 062个月经周期,其中有排卵性月经周期966个,无排卵性月经周期96个。在无排卵性月经周期中,癫痫发作频率高于有排卵性月经周期。在月经期癫痫中,有排卵性月经周期中围排卵期的发作频率要高于其他3期,而无排卵性月经周期中非月经期的癫痫发作频率明显高于围月经期。观察组泌乳素升高率、孕激素下降率及雌激素与孕激素比值明显高于对照组,差异均有统计学意义(P<0.05)。结论孕激素、雌激素与孕激素比值与围月经期癫痫密切相关,在有排卵性月经周期中,围排卵期癫痫发作频率更高;在无排卵性月经周期中,非月经期癫痫发作频率更高。

Objective To explore the influence of menstrual cycle on epileptic seizures in women.Methods Clinical date of 354 women with epilepsy in the hospital from January 2010 to December 2015 were retrospectively analyzed.Physiological characteristics and seizure information of these patients were recorded for 3consecutive cycles.The relationship between the attack frequency and menstrual cycle was analyzed.According to whether peri menstrual period was divided into two groups,of which 45 cases of patients with periodic epilepsy were observed group,and 309 cases of non menstrual epilepsy as the control group,the changes of serum hormones between the two groups were measured and compared.Results A total of 1 062 menstrual cycles were recorded in all patients,including 966 ovulatory cycles and 96 anovulatory cycles.In anovulatory cycles,the frequency of seizures was higher than that of the ovulatory cycle.During the menstrual cycle,the frequency of ovulation in the peri ovulatory cycle was higher than in the other 3phases;the frequency of non menstrual seizures in anovulatory cycles was significantly higher than that in the peri menstrual period.The rate of prolactin increase,the rate of progesterone decrease and the ratio of estrogen/pregnancy of observed group were significantly higher than those of the control group,the difference was statistically significant（P〈0.05）.Conclusion Progesterone,the ratio of estrogen/pregnancy are closely related to perimenopausal epilepsy,in the ovulatory cycle,the frequency of seizures during ovulation is higher;the frequency of seizures in the non menstrual period is higher in the absence of ovulation.