This study aims to compare the sex hormones between women with epilepsy (WWE) and their agematched controls. We postulated that a difference in etiology, may be associated with an unexpected hormonal profile. A case control study carried out at the University College Hospital, Ibadan, South western, Nigeria involving seventy-five WWE and age-matched controls. Blood samples for hormonal evaluation follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone and testosterone were taken twice from all the participants during their menstrual cycle. WWE had lower BMI (p: 0.004), cycle length (p: 0.014) and more menstrual pattern irregularities (p< 0.001.) In the pre-ovulatory phase, WWE had lower FSH levels when compared with controls, (p: 0.012). Further stratification shows a higher FSH levels among WWE on medication, (p: 0.003).In the mid-luteal phase, FSH level was lowest in WWE not on medication, WWE on medication had higher levels but lower when compared to the control group, p: 0.002. FWE had lower progesterone levels when compared with the control group, (p: 0.004) with no difference with use of AEDs. Testosterone levels were lower among those with symptomatic epilepsy, (p:0.012)WWE had lower progesterone, lower FSH and more menstrual abnormalities, compare to controls in our population.
Introduction: Neuromyelitis (NMO) is a distinct entity from multiple sclerosis and effort must be made to differentiate both entities. International Panel on Diagnosis of Multiple Sclerosis in May 2010, recommended that NMO and NMO-related disorders should be separated from typical multiple sclerosis because of different clinical course, prognosis, and underlying pathophysiology. In this communication, we present three cases to differentiate between NMO and multiple sclerosis to elucidate the diagnostic challenges in communities where facilities for investigations may be limited. Case presentation: The first case is that of a 24-year-old female Nigerian with recurrent spasm of the body, sensory symptoms and progressive blurring of vision. The second case is that of a 33-year-old female Nigerian with recurrent blurring of vision, weakness and numbness on the left side of the body. Symptoms were worsened by hot water bath and taking hot drinks. The third case is that of a 31-year-old female Nigerian with progressive fatigue, right upper limb weakness, unsteady gait and blurring of vision Conclusion: Previous others have reported that multiple sclerosis is quite rare in sub-Saharan Africa with NMO a commoner finding. In the midst of limited resources and consequently inadequate investigations, are we actually misdiagnosing multiple sclerosis?"
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