Summary of patients
| Patient 1 | Patient 2 | Patient 3 | |
|---|---|---|---|
| Age (y) | 32 | 43 | 31 |
| Epilepsy | CPS/SGS | CPS/SGS | CPS |
| EEG | L and R temp foci | R temp focus | L temp focus |
| Medications | Carbamazepine | Phenytoin phenobarbitone | Carbamazepine phenytoin |
| Irregular menses | + | + | + |
| Hirsutism | + | + | + |
| Obesity | Mild | − | Moderate |
| Striae | − | − | − |
| Weakness | Mild persistent | Moderate persistent | Moderate intermittent |
| Cortisol: | |||
| Serum (pm) (1.4–10.7 μg/dl) | 19.8–31.0 | 11.0–15.0 | 25.1–29.9 |
| Urinary (20–90 μg/24h) | 70.3–106.0 | 57–102 | 123–183 |
| ACTH (20–90 pg/ml) | 57–124 | 72–120 | 76.5–142.5 |
| Dex supp (<1 μg/dl) | + | + | + |
| EMG | Myopathic | Myopathic | Myopathic |
| Biopsy | Not done | Non-specific myopathic | Not done |
| Treatment | Ketoconazole 200 mg four times daily | Ketoconazole 200 mg three times daily | Ketoconazole 200 mg three times daily |
| Outcome: | |||
| Follow up (y) | 3 | 2 | 5 |
| Myopathy | Absent | Absent | Absent |
| Sz freqn | 92% | Seizure free | 32% |
| Menses | Regular | Hysterectomy for fibroids | Regular |
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.