A 23-year-old woman had several tonic-clonic seizures at the age of 16 and was treated with carbamazepine for some years. Thereafter the medication was tapered off and she remained seizure-free until she started to experience complex partial seizures at the age of 22.
Interictal EEG showed paroxysmal slow waves and some sharp waves in the left temporal region. Magnetic resonance imaging of the brain was normal. The patient was considered to have partial epilepsy originating from the left temporal lobe. Oxcarbazepine was started at 300 mg twice daily. She remained seizurefree, but during the first 10 months of treatment she gained 6 kg in weight, her acne became worse and she started to experience menstrual disorders. Her menstrual cycle changed from 28 days to 35-42 days.
On clinical examination the patient had acne on her face and shoulders. Ovarian ultrasonography showed polycystic ovaries. Her serum testosterone level was elevated to 5.0 nmo1/l (normal range 0.4—2.7 nmo1/l).
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