Treatment of Women With Epilepsy

Alison M. Pack, MD, Martha J. Morrell, MD

Disclosures

Semin Neurol. 2002;22(3) 

In This Article

Steroid Hormone Effects on Neuronal Excitability

Estrogen and progesterone are the principal ovarian steroid hormones, and each exerts an effect on neuronal excitability.[1,2,3] Physiological changes of ovarian steroid hormones over a reproductive cycle change seizure susceptibility in all experimental models of epilepsy.[4,5] Estrogen has a seizure-activating effect in experimental models of epilepsy and in human cerebral cortex,[6,7,8,9,10] whereas progesterone has a seizure protective effect in experimental models of epilepsy.[7,11,12,13,14,15]

Steroid hormones modulate cortical excitability. In the classical model, the steroid hormone binds to an intracellular receptor (intracytoplasmic for glucocorticoids, intranuclear for estrogen and progesterone), transforming the receptor to an active form that binds to DNA, leading to gene activation and protein synthesis. Sex steroid hormones also affect excitability by altering -aminobutyric acid (GABA)-mediated inhibition and glutamate-mediated excitation.[16]

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