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Catamenial seizures

Basem F Khishfe
BACKGROUND: Catamenial epilepsy is defined as an increase in the frequency of seizures during a particular phase of the menstrual cycle. The increased seizure frequency is attributed to the cyclic variation and neuroactive properties of endogenous steroid hormones. It is estimated that more than one-third of women with epilepsy experience catamenial seizure exacerbation. CASE REPORT: We present the case of a young female patient who presented to the emergency department with an increase in seizure frequency that coincided with her menstrual cycle, despite complete medication compliance...
September 26, 2016: Journal of Emergency Medicine
S Bangar, Abhishek Shastri, Hany El-Sayeh, Andrea E Cavanna
Women with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects...
July 2016: Functional Neurology
S Bangar, Abhishek Shastri, Hany El-Sayeh, Andrea E Cavanna
Women with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects...
July 18, 2016: Functional Neurology
Doodipala Samba Reddy
Epilepsy affects people of all ages and both genders. Sex differences are well known in epilepsy. Seizure susceptibility and the incidence of epilepsy are generally higher in men than women. In addition, there are gender-specific epilepsies such as catamenial epilepsy, a neuroendocrine condition in which seizures are most often clustered around the perimenstrual or periovulatory period in adult women with epilepsy. Changes in seizure sensitivity are also evident at puberty, pregnancy, and menopause. Sex differences in seizure susceptibility and resistance to antiseizure drugs can be studied in experimental models...
July 13, 2016: Pharmacology, Biochemistry, and Behavior
Allison Navis, Cynthia Harden
The cyclic hormonal underpinnings of catamenial seizure exacerbations are consistent with the neurophysiologic activity of estrogen and progesterone. For women with catamenial epilepsy who have regular menses, intermittent treatment approaches may be utilized. These interventions are targeted at adding or increasing anti-seizure treatments during established vulnerable days of the menstrual cycle, such as perimenstrually (C1 pattern), at ovulation (C2 pattern), and during the luteal phase (C3 pattern). The single large study of natural progesterone treatment showed benefit for women with clear perimenstrual seizure exacerbations (C1 pattern), but not for subjects with other catamenial patterns or for randomized women with epilepsy of reproductive age who did not have catamenial seizure exacerbations...
July 2016: Current Treatment Options in Neurology
Doodipala Samba Reddy
Catamenial epilepsy is a type of refractory epilepsy characterized by seizure clusters around perimenstrual or periovulatory period. The pathophysiology of catamenial epilepsy still remains unclear, yet there are few animal models to study this gender-specific disorder. The pathophysiology of perimenstrual catamenial epilepsy involves the withdrawal of the progesterone-derived GABAergic neurosteroids due to the decline in progesterone level at the time of menstruation. These manifestations can be faithfully reproduced in rodents by specific neuroendocrine manipulations...
2016: Frontiers in Cellular Neuroscience
Elizabeth E Gerard, Kimford J Meador
PURPOSE OF REVIEW: Caring for a woman with epilepsy requires familiarity with the implications of antiepileptic drugs (AEDs) for pregnancy and contraception as well as an understanding of the effects of female hormones on epilepsy. RECENT FINDINGS: AED pregnancy registries and prospective studies of cognitive development continue to confirm that valproate poses a significantly increased risk of structural and cognitive teratogenesis. In contrast, data thus far suggest that lamotrigine and levetiracetam are associated with a relatively low risk for both anatomic and developmental adverse effects, although further studies are needed for these and other AEDs...
February 2016: Continuum: Lifelong Learning in Neurology
Bhargavi Ramanujam, Amit Arora, Varun Malhotra, Deepa Dash, Santosh Mehta, Manjari Tripathi
Catamenial epilepsy (CE) is a commonly observed phenomenon among women with epilepsy, the management of which is both hormonal and non-hormonal. Progesterone therapy has been tried in these patients, as the possible mechanism of CE is withdrawal of progesterone and a higher oestrogen/progesterone ratio in the perimenstrual and periovulatory periods. Here, we describe a 24-year-old lady with multiple seizure types since childhood, which were refractory to adequate antiepileptic drug therapy after menarche with catamenial clustering of seizures...
March 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
Alison M Pack
No abstract text is available yet for this article.
May 2015: Epilepsy Currents
Yuwen Zhang, Yian Huang, Xu Liu, Guoxiang Wang, Xin Wang, Yun Wang
Catamenial epilepsy is a common phenomenon in female epileptic patients that is, in part, influenced by the 17-β-estradiol level during the menstrual cycle, which modulates the strength of the epileptic seizures. However, the underlying mechanism(s) for catamenial epilepsy remains unknown. In the present study, the effect of 17‑β‑estradiol on modulating epileptiform activities was investigated in cultured hippocampal neurons by focusing on the transient outward potassium current. Using the patch clamp technique, 17‑β‑estradiol was demonstrated to have a dose‑dependent U‑shape effect on epileptiform bursting activities in cultured hippocampal neurons; only the low dose (~0...
September 2015: International Journal of Molecular Medicine
Jie Liu, Nengwei Yu, Hongbin Sun, Yi Liang, Yan Xie, Kai Chen
Catamenial epilepsy is a periodic increase in seizure frequency in women with epilepsy during menstruation, or at any specific point in the menstrual cycle. We present five cases who attended the epilepsy outpatient clinic at the Sichuan Provincial People's Hospital, China, and who suffered catamenial epilepsy and received intermittent Levetiracetam (LEV) treatment 1 week prior to and post-menstruation around each menstrual period. The patients responded positively and seizures were controlled with a dose of 0...
July 2015: JPMA. the Journal of the Pakistan Medical Association
James D'Amour, Alejandra Magagna-Poveda, Jillian Moretto, Daniel Friedman, John J LaFrancois, Patrice Pearce, Andre A Fenton, Neil J MacLusky, Helen E Scharfman
In catamenial epilepsy, seizures exhibit a cyclic pattern that parallels the menstrual cycle. Many studies suggest that catamenial seizures are caused by fluctuations in gonadal hormones during the menstrual cycle, but this has been difficult to study in rodent models of epilepsy because the ovarian cycle in rodents, called the estrous cycle, is disrupted by severe seizures. Thus, when epilepsy is severe, estrous cycles become irregular or stop. Therefore, we modified kainic acid (KA)- and pilocarpine-induced status epilepticus (SE) models of epilepsy so that seizures were rare for the first months after SE, and conducted video-EEG during this time...
July 2015: Experimental Neurology
Andrew G Herzog, Kristen M Fowler, Michael R Sperling, Joseph M Massaro
The purpose of this study was to determine whether seizure frequency and cycle days with seizure occurrence vary across the menstrual cycle. The subjects were the first 100 women with intractable focal onset seizures, 13-45 years old, who completed the baseline phase of the National Institutes of Health (NIH) Progesterone Trial. Each subject recorded seizures and menses during a 3-month baseline phase. Data consisted of (1) seizure numbers for each cycle day and (2) cycle days with seizure occurrence. Statistical comparisons of seizure frequency and days with seizures were performed using generalized estimating equation one-way analysis of variance (ANOVA) and logistic regression followed by pairwise multiple comparisons of days based on the least square means...
May 2015: Epilepsia
Andrew G Herzog
PURPOSE: To extend our knowledge and practical application of the concept of catamenial epilepsy. METHODS: The review focuses on the impact of the NIH Progesterone Trial on our understanding of the pathophysiology and treatment of catamenial epilepsy. RESULTS: Catamenial epilepsy refers to the cyclic exacerbation of seizures in relation to the menstrual cycle. An interaction between seizures and the menstrual cycle is suggested by variations in seizure frequency according to the day, phase and ovulatory status of the menstrual cycle...
May 2015: Seizure: the Journal of the British Epilepsy Association
Erik Taubøll, Line Sveberg, Sigrid Svalheim
There is a complex, bidirectional interdependence between sex steroid hormones and epilepsy; hormones affect seizures, while seizures affect hormones thereby disturbing reproductive endocrine function. Both female and male sex steroid hormones influence brain excitability. For the female sex steroid hormones, progesterone and its metabolites are anticonvulsant, while estrogens are mainly proconvulsant. The monthly fluctuations in hormone levels of estrogen and progesterone are the basis for catamenial epilepsy described elsewhere in this issue...
May 2015: Seizure: the Journal of the British Epilepsy Association
Line Sveberg, Sigrid Svalheim, Erik Taubøll
PURPOSE AND METHODS: The treatment of women with epilepsy during pregnancy is known to increase the risk of teratogenic effects. Whether seizures during pregnancy have a deleterious effect on the developing child is difficult to determine, but recent animal studies, case studies, cohort studies and population studies have provided useful insights. RESULTS AND CONCLUSION: Seizures before pregnancy are a predictor for seizures during pregnancy, and catamenial epilepsy may also predict the course of seizures during pregnancy...
May 2015: Seizure: the Journal of the British Epilepsy Association
Sheryl R Haut
PURPOSE OF REVIEW: Many patients with epilepsy experience 'clusters' or flurries of seizures, also termed acute repetitive seizures (ARS). Seizure clustering has a significant impact on health and quality of life. This review summarizes recent advances in the definition and neurophysiologic understanding of clustering, the epidemiology and risk factors for clustering and both inpatient and outpatient clinical implications. New treatments for seizure clustering/ARS are perhaps the area of greatest recent progress...
April 2015: Current Opinion in Neurology
J A Mauri Llerda, A Suller Marti, P de la Peña Mayor, M Martínez Ferri, J J Poza Aldea, J Gomez Alonso, J M Mercadé Cerdá
INTRODUCTION: The characteristics of some population groups (patients with comorbidities, women of childbearing age, the elderly) may limit epilepsy management. Antiepileptic treatment in these patients may require adjustments. DEVELOPMENT: We searched articles in Pubmed, clinical practice guidelines for epilepsy, and recommendations by the most relevant medical societies regarding epilepsy in special situations (patients with comorbidities, women of childbearing age, the elderly)...
October 2015: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Chase Matthew Carver, Xin Wu, Omkaram Gangisetty, Doodipala Samba Reddy
Neurosteroids are endogenous regulators of neuronal excitability and seizure susceptibility. Neurosteroids, such as allopregnanolone (AP; 3α-hydroxy-5α-pregnan-20-one), exhibit enhanced anticonvulsant activity in perimenstrual catamenial epilepsy, a neuroendocrine condition in which seizures are clustered around the menstrual period associated with neurosteroid withdrawal (NSW). However, the molecular mechanisms underlying such enhanced neurosteroid sensitivity remain unclear. Neurosteroids are allosteric modulators of both synaptic (αβγ2-containing) and extrasynaptic (αβδ-containing) GABAA receptors, but they display greater sensitivity toward δ-subunit receptors in dentate gyrus granule cells (DGGCs)...
October 22, 2014: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Barbara S Koppel, Cynthia L Harden
A patient's hormonal milieu contributes to the timing of emergence of several epilepsy syndromes that are known to begin at puberty and recede with the end of reproductive potential. One's hormonal balance at any particular moment contributes to seizure occurrence in both men and women. The best studied condition, catamenial epilepsy, refers to seizure clusters occurring in a cyclical pattern related to menses. Treatment of epilepsy using hormones complements standard antiepileptic therapy and its use will be reviewed, along with some other medications unique to catamenial epilepsy, such as diuretics...
December 2014: Neurobiology of Disease
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