Seizures that occur around the menstrual cycle are called catamenial epilepsy. Studies show that changes in seizures are most often in the. Catamenial epilepsy is defined as a pattern of seizures that changes in severity during particular phases of the menstrual cycle, wherein. Epilepsy is a chronic neurological condition characterized by recurrent seizures. Catamenial epilepsy is a subset of epilepsy, which includes women whose.

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Catamenial Seizures

Please review our privacy policy. Neuroactive properties of reproductive steroids. The use of hormone replacement therapy HRTto lessen the effects of menopause, has shown severe negative effects on the seizure patterns of women with catamenial epilepsy. Several studies following HRT use in women with catamenial epilepsy have demonstrated more influencable data than animal models, in this case.

Treatment of seizures with medroxyprogesterone acetate: There are many unfortunate side effects frequently seen in progesterone therapy usage, including vaginal dryness, dyspareuniaosteoporosisand cardiovascular disease. Acta Endocrinol Copenh ; 81 1: Clomiphene is an ovulatory stimulant that is used to treat infertility in women with oligoanovulation or anovulation. In normally menstruating women, serum estradiol levels are typically present by day 10 of the menstrual cycle, and persist until ovulation.

National Center for Biotechnology InformationU. Some women with epilepsy appear to be at increased risk of ovulatory dysfunction.

Diagnosis and management of catamenial seizures: a review

Actually, there is no specific drug treatment for catamenial epilepsy, which is often refractory to many therapies. Catamenial epilepsy is believed to occur secondarily to the neuroactive catamenixl of endogenous steroid hormones and the natural cyclic variation in their serum levels throughout the menstrual cycle. The study population consisted of 52 inpatients with medically- refractory, complex, partial seizures.


Luteal classification abnormal or inadequate luteal phase cycles, days 10 to 3 is associated with a twofold or greater increase in average daily seizure occurrence during the O, L and M phases.

Diagnosis and management of catamenial seizures: a review

In experimental studies on ovariectomized animals where hormonal changes are abrupt, in contrast to the gradual hormonal changes found in the epikepsy transition, the concerted lack of estradiol and progesterone may facilitate the seizure susceptibility. Estrogens have proconvulsant and epileptogenic properties in animals and humans. Estradiol selectively regulates agonist binding sites on the N-methyl-D-aspartate receptor complex in the CA1 region of the hippocampus.

Ganaxolone may provide an effective approach for catamenial epilepsy therapy that is reliable, and that does not expose patients to the risk of hormonal side effects. Will it affect seizure control and AED levels?

The proper classification for catamenial epilepsy has been debatable for several decades. Seizure exacerbation associated with inhibition of progesterone metabolism. Fracture risk associated with use of antiepileptic drugs.

Women with catamenial epilepsy are unusually sensitive to endogenous hormonal changes. Acetazolamide, a carbonic anhydrase inhibitor, may be effectively used to treat catamenial seizures. The action mechanism of gonadotropin releasing hormone analog is the decreased luteinizing hormone and estrogen production with consequent amenorrhea.

Similar to estrogen, progesterone receptors bind several molecules other than only progesterone. These same results have not been seen in laboratory counterparts.

The diagnosis of catamenial epilepsy is established by careful assessment of menstrual and seizure diaries and characterization of cycle type and duration. Neurosteroid replacement therapy for catamenial epilepsy. New avenue of research: Ovulatory function in epilepsy. Retrieved from ” https: Because progesterone has mainly been shown to have anticonvulsant effects, and because women with catamenial epilepsy under study often had inadequate luteal-phase or anovulatory cycles, it can be hypothesized that progesterone, progesterone metabolites, or estrogen antagonists may be used in conjunction with current antiepileptic medications, to treat these patients.


Epilepsy Ontario is the voice of epilepsy in the province. Introduction Women with epilepsy may have seizure patterns associated with changes in estrogen and progesterone levels.

Studies have shown that fluctuations in female hormones prior to and during menstruation may elevate seizure frequency in some women. The aim of this review is to report preclinical and clinical evidences about the relationship between female reproductive steroids and epileptic seizures, and to describe treatment approaches for catamenial epilepsy. Jasper’s Basic Cqtamenial of the Epilepsies [Internet].

Terasawa E, Timiras PS. Since at least the Greek times, there has been documented study of women with epilepsy and its correlation to the menstrual cycle. Estrogens effects on the brain: In study by El-Khayat et al.

The mechanism by which estradiol increases neuronal excitability is not clearly understood; however, in experimental studies, there are many epilepssy influencing effects of estrogen on seizure susceptibility, such as sex, age, the hormone species natural or syntheticregional distribution of hormone receptors, treatment duration, time interval for initiation of hormonal treatment following gonadal removal, route of administration, as well as the dose. Convulsant actions of the neurosteroid pregnenolone sulfate in mice.

In a study, it was found that patients with C1 pattern of catamenial epilepsy had overall lower progesterone levels than healthy controls during the M phase. Non hormonal therapy Acetazolamide, a carbonic anhydrase inhibitor, may be cafamenial used to treat catamenial seizures.