Polycystic ovary syndrome and epilepsy

Anovulation or oligomenorrhoea is a common finding in female patients with temporal lobe epilepsy. The aetiology of menstrual disturbances may be a po lycystic ovary syndrome (PCOS). This may be induced by epilepsy itself (via interictal epileptic discharges from the temporal robes) or by anticonvuls ant medication (as has been suggested with respect to treatment with valpro ate). In case of temporal lobe epilepsy successful treatment of epileptic d ischarges (as far as possible by anticonvulsant medication) will reduce the number of PCOS in such patients. It has been suggested that valproate migh t cause an increase in the number of patients with PCOS, possibly via weigh t gain. However, a clear relationship between valproate and PCOS has not ye t been established. In many studies definition of PCOS varies. Sometimes po lycystic ovaries (PCO and not PCOS) is considered to be of clinical relevan ce. However, PCO are a common finding detected in about 20% of female patie nts. Nevertheless, in patients treated with anticonvulsant drugs one should be aware of menstrual irregularities. Gynaecological investigations will p ossibly help to diagnose PCOS.