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The authors determined the amounts of free and total 17-hydroxycorticosteroids (17-OHCS) and 17-ketosteroids (17-KS) in the urine of 11 women in whom epileptic seizures occurred most frequently on the 2nd and 1st day before menstruation and in 7 women with seizures showing no such correlation with the menstrual cycle. A statistically significant decrease of 17-KS was demonstrated in women with premenstrual seizures. In both groups of women the amounts of free 17-OHCS were near the lower normal range, while the amounts of total 17-OHCS were reduced and the obtained results compared with the accepted normal values showed statistically significant differences (p less than 0.01). The obtained results are, however, insufficient for assuming that these hormones play an important role in the mechanism of seizure release in premenstrual period. The authors think, on the other hand, that the statistically significant fall in 17-KS in women with premenstrual seizures may play some role among other factors in the mechanism of seizure release.

In 32 women with epileptic seizures related in time to the premenstrual phase (group A) and 31 women with seizures unrelated to this phase (group B) oestrone oestradiol and oestriol and progesterone metabolites (alpha and beta-pregnanediol) were determined in 24-hour urine. The investigations were carried out during 2 days preceding the onset of menstrual bleeding usually during three successive cycles. A significant reduction was observed in the amounts of all three oestrogen fractions in relation to normal values on both days (without any significant difference between the groups). Women with epilepsy excreted 56-60% less oestrogens than healthy women. Similarly the levels of alpha and beta-pregnanediol were significantly below the accepted normal range. The obtained results are insufficient for accepting the role of oestrogens in the development of lowered convulsive threshold on the days preceding menstrual bleeding. On the other hand, it may be concluded that progesterone deficiency may have an effect on the appearance of greater readiness to seizures before menstruation in epileptic women.

The authors determined the amounts of oestrone, oestradiol, oestriol, alpha and beta pregnanediol, and pregnanetriol in 24-hour urine of 11 women with epileptic seizures occurring two and one day before the onset of menstruation, and in 7 women with seizures not dependent on the menstrual cycle. Determinations of these hormons were done during three successive menstrual cycles on the 2nd and 1st day before the onset of bleeding. In both groups a significant decrease was observed in the urinary levels of oestradiol and oestriol as compared with normal values. On the other hand, the amount of excreted oestrone was only slightly lowered in relation to the amount of this hormone excreted by controls. A significant decrease in the amounts of alpha pregnanediol (the difference being statistically significant at p less than 0.01 level) was observed two days before menstruation. On the other hand, pregnanetriol was decreased only in women in whom the seizures showed no temporal correlation with the stage of the menstrual cycle. The authors suggest that the observed reduction in the metabolites of progesterone in both groups was associated with an increased seizure readiness of the brain on the days preceding menstrual bleeding.

The investigations were carried out in 10 patients with epileptic seizures. The obtained results were compared with those in a control group of 20 healthy subjects. The 24-hour urinary excretion of 5-HIAA efore hydantoinal and on the 1st, 2dn and 3rd days of hydantoinal administration was determined by the method of Udenfried et al. as modified by McFarlane et al. It was found that healthy subjects excreted significantly more 5-HIAA before and after hydantoinal load. Administration of this drug increased significantly the excretion of this metabolite with urine, in healthy subjects but in epileptics it had no significant effect on 5-HIAA level in 24-hour urine.

In 32 women with seizures occurring mainly in the premenstrual phase and during bleeding, (group A) and in 31 women with epilepsy without this relationship of the seizures to the menstrual cycle (group B) the metabolites of adrenocortical hormones (17-ketosteroids and 17-hydroxycorticosteroids) were determined in 24-hour urine. The investigations were done during 2 days preceding menstrual bleeding, in most cases during three menstrual cycles. A significant reduction of the excretion of 17-ketosteroids and total 17-hydroxycorticosteroids was found in both groups as compared to the accepted normal value (p less than 0.01). However, no significant difference was observed in the excretion of these hormones between these groups of patients, although in group A he values of 17-ketosteroids were lower than in group B. On the basis of these results it is suggested that deficiency of androgenic hormones may contribute to the occurrence of seizures on the days before the onset of menstrual bleeding, and the effect of anticonvulsant treatment on the decreased excretion of these hormones is discussed.