Case reports

A 28-year-old woman was referred to an epilepsy and neuropsychiatry service following a disastrous attempt at treating her infertility by a local gynaecological unit. At the age of 14 she had developed complex partial seizures. A single electroencephalograph (EEG) had shown epileptic activity focal to the right temporal lobe and she was placed on sodium valproate by a paediatrician. She continued to have several complex partial seizures a year despite this medication and gained a great deal of weight. Her periods became irregular and finally stopped at the age of 20. She was discharged from paediatric care at the age of 18, but was not referred for further secondary care, however, she was managed by her General Practitioner (GP) who continued her prescriptions. At the age of 22 she married and attempted to conceive. She did not become pregnant and at the age 26 was seen by a gynaecologist for her infertility. Her amenorrhoea was investigated, she was shown to have the polycystic ovary syndrome and, without further consideration, treated with clomiphene to induce ovulation—the epilepsy, and the possible consequences of the medication she was taking, were ignored even though her seizure frequency dramatically increased during the three courses of clomiphene she had: during the courses of clomiphene she received artificial insemination from her husband.