Chronic Epilepsy in Uterine Leiomyoma Controlled by Myomectomy.

Abstract

Objective: We have seen many black African women with uterine fibroids. We have also seen many with just epileptic attacks only. This is the first female, to our knowledge, to present with both afflictions; the convulsions stopping after the myomectomy. Hence, this report.
Materials and Method: This 30-year old single nulliparous black Nigerian female was first seen in August 2002 in our outpatient’s department. She had complained of having frequent generalized convulsions since 1988. Native medications had been of no help. Clinical examination revealed no gross neurological deficit, but a large uterine fibroid. With the diagnosis also of grand mal epilepsy, she was placed on epanutin and phenobarbitone, which prolonged the intervals of the attacks. She eventually asked for the removal of the fibroid, which was done on the 1st of March, 2006. She was discharged home 7 days later, when the stitches were removed, and to continue the same anti-epileptic drugs, as mentioned earlier. She was to return for follow-up checks 7 days after discharge from hospital. Result: The patient tolerated the myomectomy very well. The histopathology of the specimen was that of a leiomyoma with degenerative changes. The attacks reduced greatly in severity, with prolonged intervals, 3 months after surgery. We have not seen her again, but reports reaching us suggest that she is alive, well and free of convulsions.
Conclusion: This is an unusual case of a huge uterine leiomyoma in an epileptic female or vise versa. The removal of the tumor appeared to have controlled the seizures.

Niger Med J. Vol. 51, No. 4,Oct. – Dec., 2010: 182 – 183.

Keywords: Epilepsy, Anticonvulsants, Uterine Fibroids, Myomectomy.