Catamenial Epilepsy

Posted on
August 2, 2024
Let's learn all the facts about a brain pattern called

Catamenial Epilepsy

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Basics about Catamenial Epilepsy | Epilepsy Foundation

Treatments for seizures in catamenial (menstrual‐related) epilepsy - PMC (nih.gov)=

Catamenial epilepsy is a gender-specific type of epilepsy in which seizure frequency intensifies during certain phases of the menstrual cycle. An increase in seizures in parallel with the menstrual cycle in some women with epilepsy has been noticed since ancient time. Catamenial epilepsy is not just one entity but can occur at any phase of the menstrual cycle, i.e., it can be perimenstrual, periovulatory, or luteal.

Perimenstrual seizures are associated with an increase in seizure frequency during the menstrual phase and arise from a drastic decrease in both progesterone and estrogen levels.

Periovulatory seizures are associated with a high seizure frequency in the ovulatory phase and are attributed to a high estrogen-progesterone ratio. Since estrogen can exacerbate seizures and progesterone (which is an anticonvulsant) levels are low, this phase may be associated with seizures.

Luteal seizures are caused by low levels of progesterone and of neurosteroids (especially one known as allopregnanolone) that are derived from progesterone.

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Question:
Which of the following may aid in seizure control during the menstrual cycle for women affected by Catamenial Epilepsy?
A
Taking hormone agents
B
Increasing dose of ASM during menstruation
C
Tracking increase in seizures utilizing a diary
D
All the above
E
Correct Answer: 
D

Adjusting the dose of a seizure medication before the time of increased seizures or taking an additional seizure medication such as lorazepam (Ativan) for several days around the menstrual cycle (applies only to women with regular cycles and determined by provider). Reducing the water retention that occurs in the premenstrual period.Using hormonal agents such as progesterone or birth control pills for women with catamenial epilepsy may help.  

All women should track when their menses is due and look at other possible triggers at that time. Women sensitive to hormone changes can make sure they sleep well, don’t miss medicines, avoid other triggers, or adjust their lifestyle to lessen the risk of seizures during their menses.

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