Does the age of seizure onset relate to menarche and does it matter?

Abstract

To determine whether there is a relationship between the age of seizure onset and the age of menarche. Methods: 1144 women with epilepsy (WWE) in the community, ages 18-47 years, provided web-based survey data. We compared the frequencies of the individual differences between their ages of seizure onset and menarche to each other and chance. We determined whether the age of menarche is a predictor of the age of seizure onset and the percentage of the variance that menarche explains. We used two-step cluster analysis to autoidentify a cluster of years relative to the age of menarche that showed the greatest predilection for seizure onset. Results: Average age of menarche was 12.55 [95% CI: 12.45-12.65]. It was greater in WWE who developed seizures before versus after menarche (12.70 [12.54-12.86] v 12.42 [12.30-12.54], p = 0.006). More WWE had seizure onset during the year of menarche than during any other year (8.3% v expected 2.1%; p < 0.0001). Menarche, however, explained only 1% of the variance. Seizure onset frequencies were greatest for an autoidentified cluster that spanned 2 years before to 6 years after menarche and subsumed 49.3% of seizure onset. Conclusion:Although the results indicate a significant relationship between the age of seizure onset and the age of menarche, the broader auto-identified perimenarchal cluster that subsumes 49.3% of seizure onset suggests that research target the potential role of the great increase in adrenarchal, as well as gonadarchal, neuroactive steroids that modulate neuronal excitability and seizures during that span.These retrospective data came from the Epilepsy Birth Control Registry (EBCR) web-based survey of 1144 WWE in the community, ages 18-47 years, who provided demographic, epilepsy, antiepileptic drug (AED), reproductive and contraceptive data [8]. We conducted the EBCR survey, located at epilepsybirthcontrolregistry.com, between 2010-2014. The Western Institutional Review Board approved the study. All subjects provided online consent prior to gaining access to the survey. Referral sources included epilepsy organization websites, social

Why did my seizures start now? Influences of lesion connectivity and genetic etiology on age at seizure onset in focal epilepsy

“…Other genetic, immune, hormonal, and environmental factors might also affect seizure onset 46 . For example, the incidence of epilepsy, including FCD‐related epilepsy, 47 is greater in males, and in women with epilepsy, seizure onset is most likely to occur during the year of menarche 46 .…”

“…4 | Potential nonlesional influences on age at seizure onset Other genetic, immune, hormonal, and environmental factors might also affect seizure onset. 46 For example, the incidence of epilepsy, including FCD-related epilepsy, 47 is greater in males, and in women with epilepsy, seizure onset is most likely to occur during the year of menarche. 46 Despite these observations, there is little evidence from FCD cohorts, including ours, that sex or sex hormones influence age at seizure onset.…”

“…46 For example, the incidence of epilepsy, including FCD-related epilepsy, 47 is greater in males, and in women with epilepsy, seizure onset is most likely to occur during the year of menarche. 46 Despite these observations, there is little evidence from FCD cohorts, including ours, that sex or sex hormones influence age at seizure onset. 2,3,48 Seizure-precipitating factors such as emotional stress, head trauma, fever, sleep deprivation, and alcohol may also contribute to the exact timing of seizure onset in a predisposed individual, 49 these not being assessed in our study.…”