The Effects of Estrogen, Progesterone, and Ionized Calcium on Seizures During the Menstrual Cycle of Epileptic Women

Jacono, John; Robertson, J.M.

doi:10.1111/j.1528-1157.1987.tb03690.x

Cited by 60 publications

(32 citation statements)

References 29 publications

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“…In other studies, estrogen applied topically created new seizure foci and activated previously present cortical epileptogenic foci (24), and on a neuronal level, estrogens enhance glutamate excitation (25). Some questions remain regarding the significance of this estrogen seizure-provoking effect in humans because studies involving catamenial epilepsy have not consistently confirmed that high levels of estrogen are responsible for exacerbation of seizures (1,22,26,27). Nonetheless, the concept that estrogen may lower the seizure threshold in some individuals is reasonably well accepted.…”

Section: Discussionmentioning

confidence: 99%

Effects of Menopause on Seizures in Women with Epilepsy

et al. 1999

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Summary:Purpose: Although important associations between epilepsy and women's hormonal phases are described, the relation of menopause to epilepsy has received little attention.Methods: By using a structured interview, we studied menopausal women with epilepsy seen at the University of Maryland Epilepsy Center over a I-year period from 1994 to 1995. We analyzed the characteristics and temporal relation of the seizures to menopause and compared the frequency and severity of the seizures with those in a similar group of premenopausal women.Results: We identified 61 menopausal women (46 who were postmenopausal and 15 perimenopausal) and compared them with 46 premenopausal women. No statistically significant differences were noted in either the frequency or the severity of seizures comparing all menopausal or only postmenopausal with premenopausal women. However, 12 (20%) of the 61 menopausal women noted that their seizures first began during or after menopause, with eight having no proven cause for their seizures. Many individual women described changes in their seizures with menopause. Among the 61 menopausal women, 49 had established epilepsy before the onset of menopause, and 20 (41%) reported worsening of their seizures with menopause, 13 (27%) noted improvement, and 16 (33%) described no changes. These observations were similar for peri-and postmenopausal women. Of the 15 menopausal women taking hormone replacement therapy, the six taking progestin were significantly less likely to report worsening of their seizures.Conclusions: These findings support the view that hormonal influences are important in women with seizures. Although, in aggregate, menopausal (combined perimenopausal and postmenopausal) and postmenopausal women's seizures were similar in frequency and severity to those of other women, menopause was associated with changes in seizures for some women. Moreover, menopause may be a previously unrecognized factor for some new-onset seizures. The relations between menopause and epilepsy deserve to be more fully investigated. Key Words: Menopause-Epilepsy-SeizuresWomen-Hormones.Women with epilepsy are increasingly recognized to have special problems resulting from the complex and significant effects of reproductive phases on their seizures. The interactions of puberty, menarche, menstruation, and pregnancy with epilepsy have been studied and reviewed by several investigators (1-7). Still, little is known about the associations of epilepsy with another important female hormonal phase, menopause. Understanding this issue will be of increasing importance as the percentage of older individuals in the population increases.Indeed, menopausal women with epilepsy present a potential major public health concern. Menopause genAccepted September 8, 1998. Presented in part at the annual meeting of the American Epilepsy Society, Baltimore, Maryland, 1995. erally occurs in American women between the ages of 48 and 55 years. Current census figures indicate that we now approach a figure of 50 million American women ...

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Section: Discussionmentioning

confidence: 99%

Effects of Menopause on Seizures in Women with Epilepsy

et al. 1999

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“…There is a positive correlation between levels of P associated with the follicular phase of the menstrual cycle and increased seizure threshold (Backstrom, 1976). Women suffering from catamenial epilepsy display more dense and intense clusters of seizures during the follicular phase of the menstrual cycle, just after circulating levels of P have decreased drastically (Backstrom, 1976;Duncan, Read, & Brodie, 1993;Jacono & Robertson, 1987;Rosciszewska, Buntner, Guz, & Zawisza, 1986;Zimmerberg & Morrow, 1996). Progesterone levels are also reduced in catamenial epilepsy patients compared to normal and epileptic patients (Bonuccelli, et al, 1989;Narbone et al, 1989), and intermittent P therapy can decrease the frequency of complex partial seizures in women with epilepsy (Chia & Scarffe, 1993;Herzog, 1986).…”

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confidence: 96%

Prenatal stress reduces the effectiveness of the neurosteroid 3?,5?-THP to block kainic-acid-induced seizures

Frye

Bayon

1999

Dev. Psychobiol.

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“…There is a correlation between concentrations of P associated with the follicular phase of the menstrual cycle and increased seizure threshold [4]. Women suffering from catamenial epilepsy display more dense and intense clusters of seizures during the follicular phase of the menstrual cycle, just after circulating levels of P have decreased drastically [4, 5, 6, 7, 8]. P levels are also reduced in catamenial epilepsy patients compared to normal patients and epileptic patients [9, 10], and intermittent P therapy can decrease the frequency of complex partial seizures in women with epilepsy [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Seizure Activity Is Increased in Endocrine States Characterized by Decline in Endogenous Levels of the Neurosteroid 3α,5α-THP

Frye

Bayon²

1998

Neuroendocrinology

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To examine the role of progesterone (P) and its 5α-reduced metabolite, the neurosteroid 5α-pregnan-3α-ol-20-one (3α,5α-THP), in endogenous variations in ictal activity rats were tested for kainic acid-induced seizures in different hormonal milieu. Corresponding plasma and central P and 3α,5α-THP levels were measured. Cycling Long-Evans rats in estrus and proestrus had seizures of significantly shorter duration and more central and plasma 3α,5α-THP and P than animals in metestrus or diestrus. Females with luteal functioning had seizures of significantly shorter duration and increased central and plasma 3α,5α-THP and P compared to animals that recently had luteal functioning discontinued. Pregnant rats had significantly shorter seizures and greater central and plasma 3α,5α-THP and central P than animals tested 1–2 days postparturition. In all test paradigms, seizure activity was increased in animals that had decreased 3α,5α-THP or P; overall, central 3α,5α-THP was more inversely related to ictal activity than central P or plasma P and 3α,5α-THP. To investigate a causal relationship between 3α,5α-THP and seizures, a 5α-reductase inhibitor, finasteride, or vehicle was administered to pregnant rats. Finasteride administration significantly decreased central and plasma 3α,5α-THP, but had no significant effect on plasma or central P of pregnant rats. Finasteride, but not vehicle administration, to pregnant rats significantly increased seizure duration. These findings support the hypothesis that variations in seizure threshold over endogenous hormonal milieu may be related to endogenous 3α,5α-THP. Of all of the endocrine conditions, seizure durations were greatest in diestrus animals; this group did not experience the lowest or the greatest decrease in 3α,5α-THP concentrations; however, of all of the endocrine conditions, cycling rats experienced the most rapid cycles of 3α,5α-THP variation. This suggests that cycles of endogenous variations in 3α,5α-THP may influence seizure threshold.

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The Effects of Estrogen, Progesterone, and Ionized Calcium on Seizures During the Menstrual Cycle of Epileptic Women

Cited by 60 publications

References 29 publications

Effects of Menopause on Seizures in Women with Epilepsy

Effects of Menopause on Seizures in Women with Epilepsy

Prenatal stress reduces the effectiveness of the neurosteroid 3?,5?-THP to block kainic-acid-induced seizures

Seizure Activity Is Increased in Endocrine States Characterized by Decline in Endogenous Levels of the Neurosteroid 3α,5α-THP

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