A Comparison of the Structure and Function of Ovaries in a Group of Women without Epilepsy and in Groups of Women with Epilepsy Who Have Only Ever Taken Either Valproate, Lamotrigine or Carbamazepine.
Abstract number :
J.04
Submission category :
Year :
2001
Submission ID :
225
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
T. Betts, Birmingham University Seizure Clinic, Birmingham, United Kingdom; H. Yarrow, Birmingham University Seizure Clinic, Birmingham, United Kingdom; L. Greenhill, Birmingham University Seizure Clinic, Birmingham, United Kingdom; N. Dutton, University
RATIONALE: There is current controversy about the relationship between ovarian structure and function in women with epilepsy and whether sodium valproate increases the incidence of polycystic (polyfollicular) ovaries and the Polycystic Ovary Syndrome (PCOS) (Betts, T., Dutton, N., & Yarrow, H., 2001). Only long term, longitudinal studies of women with epilepsy from before they start medication will settle the controversy ( Reuber M. & Goulding, P. 2000 ), but evidence can be derived from other studies.
It is our present clinical policy to assess ovarian structure (with MRI scanning) and function in women with epilepsy presenting to our pre-conception counselling clinic: we have been able to compare the results of this ongoing clinical study with results obtained from a group of 50 women without epilepsy of comparable age (studied to validate our MRI technique).
METHODS: The clinical records of women with primary generalised epilepsy attending our pre-conception clinic were examined and the data of women who had only ever taken either valproate (VPA), lamotrigine (LTG) or carbamazepine (CBZ) extracted and compared with the data from the group of 50 women without epilepsy : the radiologist reading the MRI scans was blind as to whether the women were in the [dsquote]normal[dsquote] group and blind to medication taken. Ovarian structure and function were compared.
RESULTS: [table]
CONCLUSIONS: This is an on-going study but our preliminary conclusions are that women with epilepsy, whatever AED they are taking, are more likely to have polyfollicular (polycystic) ovaries, presumably an effect of epilepsy itself on midbrain gonadotrophic releasing mechanisms: the significance of possessing polyfollicular ovaries is unclear. Women with epilepsy, taking valproate, are significantly more likely to have the hormonal characteristics of the PCOS: this may be reversible on withdrawal.
REFERENCES
1. Betts, T., Dutton, N., Yarrow, H., Epilepsy and the Ovary, (Cutting out the Hysteria). Seizure 2001; 10: to be published.
2. Reuber, M. & Goulding, P. Valproate, the Polycystic Ovary Syndrome and the Need for a Prospective Study. Seizure 2000; 9: 235-236.
Support: This work was supported by an unrestricted research grant from GlaxoSmithKline.
Disclosure: Salary - HY[ssquote]s salary is obtained from an unrestricted research grant from GlaxoSmithKline. Grant - This work was supported by an unrestricted research grant from GlaxoSmithKline. Materials - MRI scanning in the normal group was supported by an unrestricted research grant from GlaxoSmithKline. Honoraria - TB has received occasional honoraria for speaking for GlaxoSmithKline.