Aatypical presentation of an infertile patient with fibroid uterus and recurrent convulsion-rare case report.
Sharmin Abbasi (BD), Sehereen Siddiqua (BD)
[Abbasi] Anwer Khan Modern Medical College Hospital, [Siddiqua] Anwer Khan Modern Medical College Hospital
Background: Uterine fibroids are usually benign tumors of the uterus. 5%-10% of infertile women have fibroids. First time in our experience epileptic attack increases with menorrhagia in an infertile patient with fibroid uterus and convulsion subsided after myomectomy. Case report: A 32 years old infertile patient married for 5 years and trying for pregnancy for last 4 years. She complaints of frequent generalized convulsions for last 2 years and menorrhagia for last 1 year. Clinically, she was anemic and had no gross neurological deficits. Per abdominal examination revealed-24 weeks pregnancy sized non-tender mass which is firm in consistancy with well defined margin and irregular surface, clinically diagnosed as uterine fibroid. The diagnosis of grand Mal Epilepsy was made from the history and Electroencephalogram (EEG).MRI of brain was normal. She was then placed on a combination of epanutin and phenobarbitone .Pt also strongly state that she had excessive bleeding during menstruation for last 1 year and with each cycle of menorrhagia she had attack of convulsion. Due to big symptomatic fibroid decided for myomectomy. . The anti-epileptic medications were continued. After myomectomy, menorrhagia subsided and no epileptic attack. We gave ovulation induction drugs for 4 cycle with letrozol and gonadotropins and the patient was conceived and after 37 completed weeks a healthy female baby was delivered. After myomectomy 5 years passed and the patient had no menorrhagia and no convulsion. Conclusion: Patient with huge fibroid with recurrent epileptic attack really an unusual case report.Convulsion controlled after myomectomy. In literature we found only 2 cases. Now it’s a matter of question that is it a coincidence or have any association.