Transcranial magnetic stimulation evidence of a potential role for progesterone in the modulation of premenstrual corticocortical inhibition in a woman with catamenial seizure exacerbation.
A transcranial magnetic stimulation paired-pulse paradigm was used to determine that cortical excitability was less during the late luteal phase than in the early follicular phase in a woman with epilepsy who had premenstrual seizure exacerbation. The data are consistent with the possibility that a reduction in GABA-mediated cortical inhibitory activity may be responsible. The administration of progesterone, a reproductive steroid with potent GABAergic metabolites, during the luteal phase restored cortical excitability to normal range.
Herzog
A G
AG
Harvard Neuroendocrine Unit, Laboratory for Magnetic Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, Massachusetts, 02215.
Friedman
M N
MN
Freund
S
S
Pascual-Leone
A
A