Catamenial Epilepsy - Update on Practical Management

Abstract

Catamenial epilepsy is a type of epilepsy that is characterized by aggravation and seizures clustering in a perimenstrual or periovulatory periods. Neuroactive properties of reproductive steroids and cyclic variations in their concentrations are important pathophysiological factors. Recent researches have demonstrated and confirmed the presence of at least three forms of catamenial aggravation of the attacks: perimenstrual and periovulatory in ovulation cycles and pattern throughout the whole luteal phase in anovulatory cycles. Rational models have identified that approximately one-third of women with epilepsy may have catamenial aggravation of the seizures. Open studies using cyclic natural progesterone as add-on therapy, medroxyprogesterone and gonadotropin-releasing hormone analogues have shown therapeutic benefits in certain forms of catamenial epilepsy. Therefore, it is important for the physician to consider catamenial epilepsy as a common type of epilepsy in women and recognize a particular pattern of this condition with the potential for good therapeutic response.