Epileptic seizure abolition with aromatase inhibition

Oestrogens are epileptogenic as they increase neural membrane excitability and lower seizure threshold. 1 Progesterone has anticonvulsant effects and testosterone has either proconvulsant or anticonvulsant action, exerted via different metabolites. 2 Studies have reported a statistically significant association between seizure frequency and serum oestradiol:progesterone ratio. 1 Epileptic patients, both men and women, have higher oestrogen levels, resulting in sexual and reproductive dysfunction. Several conventional AED including lamotrigine, oxcarbazepine, tiagabine, phenobarbital, phenytoin, ethosuximide and valproic acid inhibit aromatase to a variable extent, but this is not their primary mechanism of action.3 AI in treatment of concurrent sexual dysfunction in men with epilepsy has been described, 3 but their anticonvulsant potential per se is not confirmed.