[Neurologic pathology of hormonal contraceptives].

In the light of the literature and our own observations we must assu me that oral contraceptives may have side effects and cause neurologic complications. We have seen an increase in the incidence and intensity of migraine attacks (15 cases) papilledema (2) progressive hearing loss (2) and hemichorea (1) as well as cerebral vascular accidents in 20 out of 75 women aged below 45 years. The type of oral contraceptive and length of medication do not appear to be significant. Recent publications suggest that the estrogen dose may have a bearing but no difference is observable between combined and sequential preparations. Concomitant factors were rare in our own cases but were seen in 20 out of 80 observations reported in the literature. 18 out of our 20 cases involved unilateral symptoms and 2 patients suffered global amnesia probably as an expression of vertebral-basilar insufficiency. An arteriogram was performed in 56 out of 100 cases (from the literature and our own) and showed a vascular occlusion in 41. 2 of our own patients died 3 were very severely handicapped and the rest fully recovered. Taking the cases from the literature as well 47 out of 75 recovered. Considering the very widespread use of oral contraceptives these complications are rare. They should not lead to out-of-hand conde mnation of oral contraceptives since too many medical and sociological factors militate in favour of this medication.(AUTHORS MODIFIED)