This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract Catamenial epilepsy is defined as a pattern of seizures that changes in severity during particular phases of the menstrual cycle, wherein estrogens are proconvulsant, increasing the neuronal excitability; and progesterone is anticonvulsant, enhancing GABA-mediated inhibition. To date, there are no specific drug treatments for catamenial epilepsy however, non-hormonal and hormonal therapies have been proposed. The aim of this review is to report preclinical and clinical evidences about the relationship between female reproductive steroids and epileptic seizures, and to describe treatment approaches for catamenial epilepsy. Keywords: catamenial epilepsy, estrogens, progesterone, neurosteroids Introduction Women with epilepsy may have seizure patterns associated with changes in estrogen and progesterone levels.
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The drop in progesterone just before menstruation may trigger seizures in women with CE. The rise in estrogen during ovulation may also rigger seizures in women with CE. Diagnosis The most useful test in diagnosing seizures is an electroencephalogram EEG.
This records electrical activity in the brain. EEG can show unusual electrical activity patterns. Different types of seizures can be identified with these patterns. These images can also show where the seizure is happening in the brain. The scans can rule out other possible causes such as a stroke. Women with epilepsy should keep a record of their seizures and menstrual cycles. The doctor will then study these to see if there is any connection between the two. Treatments Medication is the most common treatment for CE.
This may include: Anti-seizure drugs Drugs to adjust the hormone levels in the body The dose of anti-seizure medication may be increased just before the time in the cycle that triggers seizures.
The goal is to prevent the seizure from happening. Drugs that can help lower estrogen or raise progesterone levels in the body may also be used. This may include: Oral contraceptives birth control pill Natural progesterone Clomiphene In extreme cases, surgery to remove the ovaries may be used to treat the condition.
The staff at the Cedars-Sinai Epilepsy Program will work with each patient to determine the best treatment option. Find A Doctor.
Progesterone Our understanding of the major gonadal hormones , estrogen , progesterone , and testosterone , has significantly increased in the last century. These hormones are synthesized in various locations in the body, including the ovaries, adrenal gland, liver, subcutaneous fat, and brain. Estrone E1 , estradiol E2 , and estriol E3 are the three principal circulating estrogens in the body. In normally menstruating women, serum estradiol levels are typically present by day 10 of the menstrual cycle, and persist until ovulation. Estrone is the major estrogen after menopause, and this hormone may be very influential in seizure control of the catamenial woman if she is severely overweight or obese.
Diagnosis and management of catamenial seizures: a review