title: Seizure exacerbation and hormonal cycles in women with epilepsy.
abstract: 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.
authors.affiliation: Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Republic of Korea.
authors.forename: Geon Ha
authors.initials: GH
authors.lastname: Kim
authors.forename: Hyang Woon
authors.initials: HW
authors.lastname: Lee
authors.forename: Hyesook
authors.initials: H
authors.lastname: Park
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
authors.forename: Sang Ahm
authors.initials: SA
authors.lastname: Lee
authors.forename: Yeong In
authors.initials: YI
authors.lastname: Kim
authors.forename: Hong Ki
authors.initials: HK
authors.lastname: Song
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Shin
authors.forename: Seung Bong
authors.initials: SB
authors.lastname: Hong
mesh_terms: 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