A Treatment Approach to Catamenial Epilepsy

Opinion statement 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. In this protocol, natural progesterone was given at a high dose during the luteal phase and was generally well tolerated. 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Epilepsia. 2001;42(6):746–9. Feely M, Calvert R and J Gibson. Clobazem in catamenial epilepsy: a model for evaluating anticonvulsants. The Lancet. 1982. 71–73 Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of Interest The authors declare that they have no conflict of interest. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors. Additional information This article is part of the Topical Collection on Epilepsy Rights and permissions About this article Cite this article Navis, A., Harden, C. A Treatment Approach to Catamenial Epilepsy. Curr Treat Options Neurol 18, 30 (2016). https://doi.org/10.1007/s11940-016-0413-6 Published: DOI: https://doi.org/10.1007/s11940-016-0413-6