Epilepsy and the ovary (cutting out the hysteria)

This review touches on the historical links between epilepsy, seizures and the uterus and ovaries which have fascinated and misled physicians since Gr eco-Roman times. It then examines present knowledge of ovarian function and its effect on epileptic activity and vice versa before exploring the moder n controversy about polycystic ovaries and the polycystic ovary syndrome, e pilepsy and anticonvulsant medication. Based on present evidence, women wit h epilepsy are more prone to develop polycystic (polyfollicular) ovaries th an other women due to the epilepsy itself. But women with epilepsy related polycystic (polyfollicular) ovaries are vulnerable to the effects of sodium valproate (possibly particularly during adolescence) and may develop the p olycystic ovary syndrome: this is reversible if the valproate is withdrawn. Lamotrigine and carbamazepine seem to prevent the development of the syndr ome. (C) 2001 BEA Trading Ltd.