4. Catamenial Epilepsy

  1. Cynthia L. Harden MD Professor of Neurology2,
  2. Sanjeev V. Thomas MD, DM Professor of Neurology3 and
  3. Torbjörn Tomson MD, PhD Professor of Neurology and Epileptology4
  1. Erik Taubøll,
  2. Line S. Røste and
  3. Sigrid Svalheim

Published Online: 24 JAN 2013

DOI: 10.1002/9781118531037.ch4

Epilepsy in Women

Epilepsy in Women

How to Cite

Taubøll, E., Røste, L. S. and Svalheim, S. (2013) Catamenial Epilepsy, in Epilepsy in Women (eds C. L. Harden, S. V. Thomas and T. Tomson), John Wiley & Sons, Oxford. doi: 10.1002/9781118531037.ch4

Editor Information

  1. 2

    Chief, Division of Epilepsy and Electroencephalography, Hofstra North Shore-LIJ School of Medicine, Cushing Neuroscience Institutes, Brain and Spine Specialists, North Shore-Long Island Jewish Health System, Great Neck, New York, USA

  2. 3

    Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala State, India

  3. 4

    Karolinska Institutet, Stockholm, Sweden

Author Information

  1. Department of Neurology, Oslo University Hospital – Rikshospitalet, Oslo, Norway

Publication History

  1. Published Online: 24 JAN 2013
  2. Published Print: 11 MAR 2013

ISBN Information

Print ISBN: 9780470672679

Online ISBN: 9781118531037

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Keywords:

  • catamenial epilepsy;
  • hormones;
  • hormonal treatment;
  • estrogens;
  • progesterone

Summary

Catamenial epilepsy denotes an association between the menstrual cycle and seizure frequency. This is commonly defined as an average doubling in daily seizure frequency during the phase of exacerbation. Using this definition, up to one-third of women with epilepsy will qualify for the diagnosis. Catamenial epilepsy occurs with all seizure types. The exact causes of catamenial epilepsy are still not entirely clear. Potential mechanisms include (i) fluctuations in antiepileptic drug concentrations and (ii) cyclic changes in reproductive steroid hormones. There is now evidence that reproductive steroids play an important role in the pathophysiology of catamenial epilepsy, with a relationship, in particular, between seizure frequency and estrogen/progesterone ratio. There is no established treatment for catamenial epilepsy, and treatment strategies are either hormonal or nonhormonal. There is now good evidence that hormonal treatment is effective in selected patients.