Seizure exacerbation and hormonal cycles in women with epilepsy.
OBJECTIVE
To investigate seizure frequency in relation to menstrual cycles and seizure exacerbations with respect to various clinical factors in women with epilepsy.


METHODS
The authors prospectively evaluated premenopausal women with epilepsy aged 15-44. Catamenial epilepsy was defined as seizure frequency during the perimenstrual (C1), periovulatory (C2) or non-menstrual phase (C3) at least twice that during other phases.


RESULTS
In total 255 menstrual cycles, 231 ovulatory and 24 anovulatory cycles were registered in 79 patients (29.7+/-7.8 years old). Average seizure frequency was 0.13+/-0.29/day during the menstrual phase, 0.14+/-0.24 during the follicular, 0.18+/-0.61 in the ovulatory, and 0.14+/-0.33 during the luteal phases. Catamenial seizure exacerbation was observed in 37/79 (46.8%) patients and 108/255 (42.4%) cycles, more frequently during anovulatory (17/24, 70.8%) than ovulatory (91/231, 39.4%) cycles (p=0.003). During ovulatory cycles, seizure exacerbation was primarily C1 (42.9%) or C2 (45.1%) pattern. Myoclonic seizures were more frequently associated with the C1 pattern.


CONCLUSIONS
Overall, 46.8% of women had catamenial epilepsy. Seizure frequencies were greater during menstrual and ovulatory phases for ovulatory cycles, and during non-menstrual phases for anovulatory cycles.
Kim
Geon Ha
GH
Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Republic of Korea.
Lee
Hyang Woon
HW
Park
Hyesook
H
Lee
Sang Kun
SK
Lee
Sang Ahm
SA
Kim
Yeong In
YI
Song
Hong Ki
HK
Shin
Dong Jin
DJ
Hong
Seung Bong
SB
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D004827:Epilepsy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology*; D010060:Ovulation / Q000502:physiology*; D011446:Prospective Studies; D012640:Seizures / Q000503:physiopathology*; D018709:Statistics, Nonparametric