Main Article Content
The frequency of seizures in many female epilepsy patients can be affected by theirmenstruation cycle: a phenomenon known as ‘catamenial epilepsy’. This can beclassifi ed into three types-C1 (perimenstrual catamenial epilepsy), C2 (periovulatorycatamenial epilepsy), and C3 (inadequate luteal catamenial epilepsy). Hormonalcontraception can also affect the control of a seizure as well as the level of someantiepileptic medications, while some anticonvulsive agents can also reduce theeffi cacy of contraceptive pills. There is still limited evidence on the treatment ofcatamenial epilepsy, but a variety of therapeutic regimens can be tried includinghormonal therapy, modifi cation of antiepileptic medication regimen during themenstruation cycle, intermittent benzodiazepine, intermittent acetazolamide, or someinvestigative agents such as neuroactive steroid ganaxolone.
This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
2. Reddy DS. Role of neurosteroids in catamenial epilepsy. Epilepsy Res 2004;62:99-118.
3. Scharfman HE, MacLusky NJ. The influence of gonadal hormones on neuronal excitability, seizures, and epilepsy in the female. Epilepsia 2006;47:1423-40.
4. Reproductive Development & Function of the Female Reproductive System. In: Barrett KE, Barman SM, Boitano S, et al, eds. Ganong’s Review of Medical Physiology (24th ed.). New York: McGraw-Hill, 2012:391-418.
5. Normal menstrual cycle. (Accessed December 10, 2014, at http://upload.wikimedia.org/wikipedia/commons/2/2a/MenstrualCycle2_en.svg.)
6. Herzog AG, Klein P, Ransil BJ. Three patterns of catamenial epilepsy. Epilepsia 1997;38:1082-8.
7. Pennell PB. Hormonal aspects of epilepsy. Neurol Clin 2009; 27:941-65.
8. Levin ER, Hammes SR. Estrogens and progestins. In: Brunton LL, Chabner BA, Knollmann BC, et al, eds. Goodman & Gilman’s pharmacological basis of therapeutics (12th ed.). New York: McGraw-Hill, 2011;1163-94.
9. Pennell PB. Antiepileptic drug pharmacokinetics during pregnancy and lactation. Neurology 2003;61:S35-42.
10. Sabers A, Ohman I, Christensen J, et al. Oral contraceptives reduce lamotrigine plasma levels. Neurology 2003;61:570-1.
11. Reimers A, Helde G, Brodtkorb E. Ethinyl estradiol, not progestogens, reduces lamotrigine serum concentrations. Epilepsia 2005;46:1414-7.
12. Herzog AG, Blum AS, Farina EL, et al. Valproate and lamotrigine level variation with menstrual cycle phase and oral contraceptive use. Neurology 2009;72:911-4.
13. De Haan GJ, Edelbroek P, Segers J, et al. Gestationinduced changes in lamotrigine pharmacokinetics: a monotherapy study. Neurology 2004;63:571-3.
14. Guberman A. Hormonal contraception and epilepsy. Neurology 1999;53:S38-40.
15. Herzog AG. Intermittent progesterone therapy and frequency of complex partial seizures in women with menstrual disorders. Neurology 1986;36:1607-10.
16. Herzog AG. Progesterone therapy in women with complex partial and secondary generalized seizures. Neurology 1995;45:1660-2
17. Herzog AG. Progesterone therapy in women with epilepsy: a 3-year follow-up. Neurology 1999;52:1917-8.
18. Herzog AG, Fowler KM, Smithson SD, et al. Progester one vs placebo therapy for women with epilepsy: A randomized clinical trial. Neurology 2012;78:1959-66.
19. Feely M, Calvert R, Gibson J. Clobazam in catamenial epilepsy. A model for evaluating anticonvulsants. Lancet 1982;2:71-3.
20. Lim LL, Foldvary N, Mascha E, et al. Acetazolamide in women with catamenial epilepsy. Epilepsia 2001;42:746-9.
21. Reddy DS, Rogawski MA. Neurosteroid replacement therapy for catamenial epilepsy. Neurotherapeutics 2009;6:392-401.