Estrogens and neuronal excitability: a case report

Introduction In several animal studies it has been documented that estrogens may contribute in seizure susceptibility. Furthermore, Logothesis et al. showed that intravenously administered conjugated estrogen clearly activated epileptitbrm discharges in a group of patients with epilepsy. Case report A woman, aged 31 years, affected by idiopalhic generalized epilepsy presenting absence and generalized tonic-clonic seizures from the age of 8 years, has been followed at our Epilespy and Pregnancy Service, in collaboration with the colleagues of reproductive pathology. The patient underwent in vitro 1er-tilization (F1VET) that requires the administration of FSH in order to stimulate several follicles and therefore a high production of estrogens. During hormonal stimulation, EEC showed a significant increase of paroxystic anomalies (spikewaves and polyspike-waves), in absence of concomitant seizures. After therapy withdrawal, the EEG returned to normal ranges. Discussion As proven in animal models and in a tew published papers in man, estrogens are able to lower neuronal excitability. Our case demonstrates the correlation between hormonal administration and increase in paruxystic anomalies on EEG. Since in clinical practice questions about hormonal stimulation in patients with epilepsy are becoming frequent, we underline the importance of further studies in order to clarify the correct management of this kind of patient.