The experience of using progesterone during pregnancy in women with epilepsy


Cite item

Full Text

Abstract

The article examines the dependence of the course of epilepsy on the concentration of progesterone in the blood serum during pregnancy. A case history of 36-year-old patient with symptomatic focal occipital epilepsy on the background of neoplasm of the brain is described. At 11 weeks of pregnancy, she was found to have a decrease in the level of progesterone to 21.7 nmol/l at a concentration of levetiracetam 31.2 μg/ml. The addition of progesterone to the therapy of 600 mg/day allowed to gradually increase the concentration of progesterone to a sufficient level of 440 nmol/l, which was accompanied by an increase in the concentration of levetiracetam in the blood to 49.8 μg/ml without increasing the dose of the anticonvulsant drug. As a practical conclusion, it is recommended to use during pregnancy correction of the level of progesterone in the blood as a measure to prevent the recurrence of epileptic seizures.

About the authors

E V Tsallagova

V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation

Email: gogayeva@mail.ru
канд. мед. наук, врач акушер-гинеколог. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4

V O Generalov

V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation

д-р мед. наук, врач-невролог 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4

O L Polyanchikova

V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation

Email: Polyanchikova_o@mail.ru
д-р мед. наук, проф., врач акушер-гинеколог, зав. акушерским обсервационным отд-нием 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4

T R Sadykov

V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation

Email: veeg.russia@gmail.com
канд. мед. наук, врач-невролог, Центр диагностики и лечения эпилепсии 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4

References

  1. Bardy A.H. Incidence of seizures during pregnancy, labor and puerperium in epileptic women: a prospective study. Acta Neurol Scand 1987; 75 (5): 356-60.
  2. Tanganelli P, Regesta G. Epilepsy, pregnancy, and major birth anomalies: an Italian prospective, controlled study. Neurology 1992; 42 (4): 89-93.
  3. Foldvary-Schaefer N. Hormones and seizures. Cleve Clin J Med 2004; 71 (2): 11-8.
  4. Morrell M.J, Sperling M.R, Stecker M. et al. Sexual dysfunction in partial epilepsy: a deficit in physiologic sexual arousal. Neurology 1994; 44: 243-7.
  5. Hussain Z, Hasan K.Z, Aziz H. et al. Clinical and neurological study of women with precatamenial epilepsy. J Coll Physicians Surg Pak 2007; 17 (4): 211-4.
  6. Herzog A.G, Fowler K.M, Sperling M.R. Distribution of seizures across the menstrual cycle in women with epilepsy. Epilepsia 2015; 56 (5): 58-62.
  7. Rosciszewska D. Analysis of seizure dispersion during menstrual cycle in women with epilepsy. Monogr Neural Sci 1980; 5: 280-4.
  8. Belelli D, Lambert J.J. Neurosteroids: endogenous regulators of the GABA (A) receptor. Nat Rev Neurosci 2005; 6: 565-75.
  9. Reddy D.S, Gould J, Gangisetty O. A mouse kindling model of perimenstrual catamenial epilepsy. J Pharmacol Exp Ther 2012; 341 (3): 784-93.
  10. Taubøll E, Sveberg L, Svalheim S. Interactions between hormones and epilepsy. Seizure 2015; 28: 3-11.
  11. Herzog A.G, Blum A.S, Farina E.L. et al. Valproate and lamotrigine level variation with menstrual cycle phase and oral contraceptive use. Neurology 2009; 72 (10): 911-4.
  12. Reddy D.S. Pharmacology of catamenial epilepsy. Methods Find Exp Clin Pharmacol 2004; 26 (7): 547-61.
  13. Grunewald R.A, Aliberti V, Panayiotopoulos C.P. Exacerbation of typical absence seizures by progesterone. Seizure 1992; 1 (2): 137-8.
  14. Yust-Katz S, de Groot J.F, Liu D. Pregnancy and glial brain tumors. Neuro Oncol 2014; 16 (9): 1289-94.
  15. Glauser T, Ben-Menachem E, Bourgeois B. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia 2013; 54 (3): 551-63.
  16. Tomson T, Palm R, Källén K. Pharmacokinetics of levetiracetam during pregnancy, delivery, in the neonatal period, and lactation. Epilepsia 2007; 48 (6): 1111-6.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2017 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).