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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This is especially the case for those who experience complex partial seizures. Estrogen can be found in the female body in various forms, all of which affect women with catamenial epilepsy.

Catamenial Seizures – Epilepsy Ontario

Ganaxolone, a synthetic analog of allopregnanolone, is able to modulate most GABA-A receptors and is under investigation for the treatment of epilepsy. Probably, the sudden withdrawal of progesterone, analogous to a benzodiazepine withdrawal, could be the cause of the premenstrual rise in seizure frequency, while, during the days preceding ovulation, the rapid and steep rise in serum estradiol concentration is believed to be responsible for the increase of seizures at that time.

It causes a transient increase in dendritic spines over the first 6 hours of exposure, followed by a decrease in the number of CA1 dendritic spines and excitatory synapses. In catamenial epilepsy seizures tend to cluster in relation to the menstrual cycle; 4 this may be construed as a greater increase in seizure frequency during a particular phase of the menstrual cycle.

Hormonal therapy 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.


Catamenial epilepsy is defined as a pattern of seizures that changes in severity during particular phases of the menstrual cycle, wherein estrogens are proconvulsant, increasing the neuronal excitability; and progesterone is anticonvulsant, enhancing GABA-mediated inhibition.

Ovarian steroid modulation of seizure severity and hippocampal cell death after kainic acid treatment. Anticonvulsant activity of neurosteroids: Women with catamenial epilepsy may experience an increase in seizure frequency in perimenopause and a decrease after menopause, which is consistent with the high estrogen levels in perimenopause, and low estrogen levels in postmenopause.

This page was last edited on 27 Decemberat Anticonvulsant medication may further aggravate mood swings, often pronounced prior to and during menstruation. Progesterone therapy in women with epilepsy: The effects of estrogen, progesterone, and ionized calcium on seizures during the menstrual cycle of epileptic women. Progesterone also antagonizes estrogen actions, lowering estrogen receptor number. Estrone E1estradiol E2and estriol E3 are the three principal circulating estrogens in the body.

Therefore, this drug can only be administered on an intermittent basis, which is appropriate for catamenial epilepsy but not for ordinary seizure prophylaxis.

Diagnosis and management of catamenial seizures: a review

This is an Open Access article which permits unrestricted noncommercial use, cataemnial the original work is properly cited. 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.

It is clear, however, that tolerance develops, which results in diminishing efficacy over time.


Epildpsy N, Falcone T. Adult female rats that have been ovariectomized, a parallel state to menopause, show increased seizure frequency overall. Relationship between epilepsy and the menstrual cycle Catamenial epilepsy is believed to occur secondarily to the neuroactive properties of endogenous steroid hormones and the natural cyclic variation in their serum levels throughout the menstrual cycle.

Catamenial Seizures

The diagnosis of catamenial epilepsy is established by careful assessment of menstrual and seizure diaries and characterization of cycle type and duration. Ganaxolone Presurgical Study Group. Water retention, electrolyte imbalance, and even poor sleep are also contributing causes. Neuroactive properties of reproductive steroids. During menopausethere are drastic changes in the production of gonadal hormones.

Large multicenter trials are needed to identify the most effective treatment for women with catamenial epilepsy.

However HRT use after perimenopause has been significantly associated with an increase in seizure frequency and severity. Definition, prevalence, pathophysiology and treatment”.

Diagnosis and management of catamenial seizures: a review

Each patient was studied for up to 8 days, with patients receiving placebo or ganaxolone. Progestin receptors mediate progesterone suppression cayamenial epileptiform activity in tetanized hippocampal slices in vitro. Estradiol regulates hippocampal dendritic spine density via an N-methyl-D-aspartate receptor-dependent mechanism.

Even though estrogen is a proconvulsant, combined oral contraceptives have not been associated with an increase in seizures.