女性癫痫患者癫痫发作与月经周期的关系  

Correlation of epileptic seizure with menstrual cycles in epileptic women

作　　者：杨艳艳[1] 赵磊[2] 李攀[2] 代聪伟[1] 梁传栋[2] 褚兆萍 

机构地区：[1]河北省人民医院妇二科,石家庄050051 [2]河北省人民医院神经外二科,石家庄050051 [3]河北省人民医院妇一科,石家庄050051

出　　处：《第三军医大学学报》2016年第5期517-521,共5页Journal of Third Military Medical University

摘　　要：目的分析女性癫痫患者癫痫发作频率与月经周期的关系，鉴别不同类型的月经期癫痫，评价其与癫痫发作和癫痫综合征的关系。方法 选取2012-2014年在我院神经外二科（癫痫中心）就诊的16～45岁女性癫痫患者59例，记录其连续3个月经周期的癫痫发作情况及生理特征，按照围月经期型、围排卵期型和黄体功能缺陷型将月经期癫痫进行分类分析。结果 共记录59例患者总计177个月经周期，其中排卵性周期161个，无排卵月经周期16个。在无排卵周期中，癫痫发作频率为（0.34±0.96）次/d，高于排卵性周期[（0.17±0.48）次/d]。在所有月经周期中共记录到42.4%（75/177）月经期癫痫，（28/59）47.5%患者被诊断患有月经期癫痫。在排卵性周期中，月经期癫痫主要出现在围月经期（27/63，42.9%）和围排卵期（28/63，44.4%）；而在无排卵周期中，主要出现在非月经期（8/12，66.7%）。在75次月经期癫痫中，排卵性周期中围排卵期的发作频率（0.57±0.31）次/d要高于其他三期；而无排卵周期中非月经期的癫痫发作频率（0.33±0.12）次/d是围月经期（0.11±0.02）次/d的3倍。在月经期癫痫中，肌阵挛发作频率增加常表现为排卵性周期中的围月经期型。结论 月经期癫痫出现在47.7%的青春期和生育期女性癫痫患者中，在排卵性周期中，围排卵期癫痫发作频率更高；在无排卵周期中，非月经期癫痫发作频率更高。Objective To investigate the correlation of seizure frequency with menstrual cycles in women with epilepsy, identify different catamenial epilepsy patterns, and to assess the relationships between seizure and epileptic syndrome. Methods Fifty-nine women with epilepsy aged from 16 to 45 admitted in the epilepsy center of our hospital （the second neurosurgery department） from 2012 to 2014 were enrolled in this study. Menstrual and seizure information of these patients were recorded for 3 consecutive cycles. Catamenial epilepsy was classified into 3 patterns, perimenstrual, periovulatory and non-menstrual phase. Results In the total obtained 177 menstrual cycles, 161 ovulatory and 16 anovulatory cycles were registered in 59 patients. Average seizure frequency was 0.34±0.96 per day during the anovulatory cycles, more than which was 0.17±0.48 per day during the ovulatory cycles. Catamenial epilepsy was observed in 28/59 （47.5%） patients and 75/177 （42.4%） cycles. During ovulatory cycles, catamenial epilepsy was primarily perimenstrual pattern （27/63, 42.9%） and periovulatory pattern （28/63, 44.4%）, which was non-menstrual pattern （8/12, 66.7%） during anovulatory cycles. In 75 catamenial epilepsy, seizure frequency for the ovulatory phase （0.57±0.31 per day） was higher than the other 3 phases, and during anovulatory cycles, seizure frequency for non-menstrual （0.33±0.12 per day） was 3 times more than for menstrual phases （0.11±0.02 per day）. Myoclonic seizures were more frequently associated with perimenstrual pattern during vulatory cycles. Conclusion Catamenial epilepsy is found in 47.7% premenopausal women. The highest seizure frequency is in ovulatory phase during ovulatory cycles or in non-menstrual phase during vulatory cycles.

关 键 词：月经 癫痫 排卵性周期 无排卵周期 

分 类 号：R339.22[医药卫生—人体生理学] R711.51[医药卫生—基础医学]