Temporal Lobe Epilepsy Exacerbation During Pharmacological Inhibition of Endogenous Neurosteroid Synthesis

The document reported a case of a woman with cryptogenic temporal lobe seizures, initially controlled with carbamazepine, but relapsed despite add-on lamotrigine treatment. She had been taking finasteride for mild hirsutism, which is known to inhibit neurosteroid synthesis. Upon discontinuing finasteride, her seizure control improved promptly. This case suggested that endogenous neurosteroids might modulate seizure susceptibility and response to antiepileptic drugs in humans, indicating their potential as a therapeutic option.