Summary of patients

Patient 1Patient 2Patient 3
Age (y)324331
EpilepsyCPS/SGSCPS/SGSCPS
EEGL and R temp fociR temp focusL temp focus
MedicationsCarbamazepinePhenytoin phenobarbitoneCarbamazepine phenytoin
Irregular menses+++
Hirsutism+++
ObesityMildModerate
Striae
WeaknessMild persistentModerate persistentModerate intermittent
Cortisol:
 Serum (pm) (1.4–10.7 μg/dl)19.8–31.011.0–15.025.1–29.9
 Urinary (20–90 μg/24h)70.3–106.057–102123–183
ACTH (20–90 pg/ml)57–12472–12076.5–142.5
Dex supp (<1 μg/dl)+++
EMGMyopathicMyopathicMyopathic
BiopsyNot doneNon-specific myopathicNot done
TreatmentKetoconazole 200 mg four times dailyKetoconazole 200 mg three times dailyKetoconazole 200 mg three times daily
Outcome:
 Follow up (y)325
 MyopathyAbsentAbsentAbsent
 Sz freqn92%Seizure free32%
 MensesRegularHysterectomy for fibroidsRegular
  • CPS=complex partial seizures; SGS=secondary generalised seizures; L=left; R=right; temp=temporal; irregular menses=irregular or <25 or >32 day interval menstrual cycles; weakness: mild= >4.5/5 strength, moderate= >4/5 strength; Dex supp=dexamethasone suppression test; sz freqn=seizure frequency during follow up period compared with baseline.