title: Menstrual cycle worsening of epileptic seizures in women with symptomatic focal epilepsy.
abstract: BACKGROUND
  Hormonal fluctuation is responsible for worsening of epileptic seizures during the menstrual cycle.
  
  
  OBJECTIVE
  To identify irregularities in the menstrual cycles of women with mesial temporal lobe epilepsy (MTLE) and extratemporal focal epilepsy (ETFE) and correlate the frequency of seizures during the menstrual cycles.
  
  
  METHODS
  We evaluated prospectively women in the menacme with MTLE and ETFE. Calendars were provided for these patients, and they were asked to mark their seizure frequency according to the menses. Calendars were reviewed in each routine medical appointment.
  
  
  RESULTS
  Thirty-nine patients with MTLE and 14 with ETFE were evaluated. We registered 211 cycles in the patients with MTLE and 49 in those with ETFE. Irregular menstrual cycles were found in 28 (28/39, 71.7%) patients with MTLE and 6 (6/14, 42.8%) with ETFE (p=0.052). Premenstrual seizure worsening was observed in 46 (21.8%) patients with MTLE and 9 (18.3%) with ETFE (p=0.596). Menstrual worsening was observed in 47 (22.2%) patients with MTLE and 15 (30.6%) with ETFE (p=0.217). Ovulatory worsening was observed in 36 (17%) patients with MTLE and 13 (26.5%) with ETFE (p=0,126). Catamenial worsening was observed in 58 (27.4%) of the patients with MTLE and in 17 (34.7%) of the patients with ETFE (p=0.315).
  
  
  CONCLUSIONS
  There was no difference between the group of patients with MTLE and ETFE regarding the frequency of irregular cycles and seizure worsening during the premenstrual, menstrual, catamenial or ovulatory periods.
authors.affiliation: Department of Neurology, FCM, UNICAMP, Campinas, SP, Brazil.
authors.forename: Ana Carolina Belini
authors.initials: AC
authors.lastname: Bazán
authors.forename: Maria Augusta
authors.initials: MA
authors.lastname: Montenegro
authors.forename: Fernando
authors.initials: F
authors.lastname: Cendes
authors.forename: Li Li
authors.initials: LL
authors.lastname: Min
authors.forename: Carlos A M
authors.initials: CA
authors.lastname: Guerreiro
mesh_terms: D000293:Adolescent; D000328:Adult; D004569:Electroencephalography; D017034:Epilepsy, Frontal Lobe / Q000503:physiopathology*; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008597:Menstrual Cycle / Q000502:physiology*; D008598:Menstruation / Q000502:physiology; D008875:Middle Aged