Epilepsy and Menstiuation. THK Role of Water Retention

Ansell, Barbara M.; Clarke, Edwin; Laidlow, J M

doi:10.1097/00006254-195708000-00032

Cited by 10 publications

(18 citation statements)

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“…Our results are in agreement with Herzog et al (1997), who reported catamenial tendencies in approximately one‐third of women with epilepsy, while Penovich (2000), found that between 30% and 50% of women with epilepsy have predictable changes in seizure frequency in concert with the menstrual cycle. On the other hand, Duncan et al (1993) reported a lower incidence of catamenial seizure in 12%, while other investigators reported that between 63% and 78% of women with epilepsy suffer from catamenial pattern, all of whom used a simply “greater than” criterion for the designation of catamenial epilepsy (Ansell & Clarke, 1956; Laidlaw, 1956; Rosciszewska, 1980; Tauboll et al, 1991).…”

Section: Discussionmentioning

confidence: 98%

Reproductive hormonal changes and catamenial pattern in adolescent females with epilepsy

et al. 2008

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SUMMARYPurpose: We aimed to evaluate the effect of epilepsy on the reproductive hormones levels among female patients, and to investigate the frequency of catamenial pattern of seizures. Methods: A total of 42 female patients with epilepsy and 21 healthy females (control group) were included. Subjects were at least 2 years postmenarche with regular cycles. Symptoms of premenstrual syndrome (PMS) were assessed using calendar of premenstrual experience scoring. Patients were evaluated for catamenial pattern of seizures. Levels of FSH, LH, estradiol (E), and progesterone (P) were assessed for all subjects in the three phases of the cycles. Pelvi-abdominal ultrasound was performed near time of ovulation, to follow up size of mature follicle. Results: Symptoms of PMS were not different in patients and controls, or in patients with and those without catamenial tendency. In both perimenstrual (M) and midluteal phases, FSH and P levels were lower and E/P ratio higher in patients group. There was a catamenial pattern of seizures in 31% of patients (53.8% M C 1 ; 46.15% inadequate luteal phase C 3 pattern). Patients with C 3 pattern showed lower P levels in the midluteal phase compared to patients with noncatamenial pattern, to those with C 1 pattern or to controls. Patients with C 1 pattern had lower P levels than controls in the M phase. Conclusion: There was evident disruption in the reproductive hormones in female patients with epilepsy with lower FSH and P levels and higher E/P ratio. A total of 31% of patients showed catamenial pattern of seizures (C 1 and C 3 patterns) that was significantly related to P withdrawal.

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Section: Discussionmentioning

confidence: 98%

Reproductive hormonal changes and catamenial pattern in adolescent females with epilepsy

et al. 2008

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“…Such action, not directly related to the sex hormone reproductive tissue activity of these compounds, is consistent with the observation that some analogs or metabolites of progesterone have more potent antiepileptic effects than the steroid hormone most active in producing sexual effects (Craig, 1966;Holmes et al, 1984). Other factors that could contribute to changes in seizure frequency during the menstrual cycle might be indirect sex hormone influences through changes in water retention (Ansell and Clarke, 1956), drug pharmacokinetics (Fernandez-Pol and Zaninovich, 1975;Shavit et al, 1984) or behavioral state (Bandler et al, 1957). In our study (Mattson et al, 1984a,b) of women treated with MPA, a synthetic progestin having relatively weak antiepileptic properties (Meyerson, 1967), improved seizure control correlated best with development of amenorrhea after administration of parenteral MPA (Mattson et al, 1985) rather than with the blood level of MPA.…”

Section: Progesteronementioning

confidence: 99%

Epilepsy, Sex Hormones, and Antiepileptic Drugs

1985

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Many factors associated with hormone function have an impact on the course of epilepsy. Patients with epilepsy may have disturbances in sexual function such as anovulatory cycles in women and decreased libido and potency in men. Data indicate seizures, especially those arising in the limbic system, may influence the hypothalamic pituitary axis. Antiepileptic drugs also influence sexual function through direct brain effects as well as through induced changes in pharmacokinetics of the sex steroid hormones. Pregnancy has been reported to be a time of increased seizures; however, this has often been associated with low drug levels, for reasons that include inadequate drug dose, possible changes in pharmacokinetics, and noncompliance. Some evidence suggests that hormones affect seizure frequency. Changes in seizures during the menstrual cycle (catamenial epilepsy) have been found in some women: seizures were fewer during the luteal phase but increased when progesterone levels declined. Some improvement in seizure frequency has been shown in pilot studies using medroxyprogesterone acetate, a synthetic progesterone. Current concepts of the interrelationship among epilepsy, sex hormones, and antiepileptic drugs are discussed.

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“…In contrast, fewer women (34.7%) qualify if a twofold increase in seizure frequency is required and only 11.2% qualify if a threefold increase is required ( Table 5). (19), 67% of Rosciszewska (24), and 63% of Ansell and Clarke (25), all of whom used a simply "greater than" criterion for the designation of catamenial epilepsy. In contrast, Duncan et al (27), who identified 12.5% of women as having catamenial epilepsy, established an approximately sixfold increase in average daily seizure frequency by requiring that three quarters of seizures occur during a 10-day period around menstruation for the designation.…”

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confidence: 99%

Three Patterns of Catamenial Epilepsy

1997

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Summary:Purpose: On the basis of the neuroactive properties of estradiol and progesterone and the menstrually related cyclic variations of their serum concentrations, we propose the existence of three hormonally based patterns of seizure exacerbation. Because previous reports both support and refute the concept of catamenial epilepsy, we test the hypothesis by charting seizures and menses and measuring midluteal serum progesterone levels to estimate the frequency of epileptic women with catamenial seizure exacerbation.Methods: One hundred eighty-four women with intractable complex partial seizures (CPS) charted their seizure occurrence and onset of menstruation on a calendar for one cycle during which they had a midluteal blood sample taken for serum progesterone determination on day 22. Levels >5 ng/ml were considered ovulatory. The cycle was divided into four phases with onset of menstruation being day 1: menstrual (M) = -3 to +3, follicular (F) = 4 to 9, ovulatory (0) = 10 to -13, and luteal (L) = -12 to -4. Average daily seizure frequency for each phase was calculated and compared among phases by repeatedmeasures analysis of variance (ANOVA) and the StudentNewman-Keul's test, separately for ovulatory and anovulatory cycles.Results We propose the existence of three hormonally based patterns of seizure exacerbation in epilepsy (1). Seizures do not occur randomly in most men and women with epilepsy (2). They tend to cluster in >50% of cases (2). Seizure clusters in turn may occur with temporal rhythmicity in a significant proportion of men (29%) and women (35%) with epilepsy (3). In women, seizures may cluster in relation to the menstrual cycle; such seizures are commonly termed catamenial epilepsy (4) and may be attributable to (a) the neuroactive properties of steroid hormones and (b) the cyclic variation in serum levels.Estradiol inhibits y-aminobutyric acid (GABA) and potentiates glutamatergic transmission (5). It increases neuronal metabolism and discharge rates (5,6). It pro-

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Epilepsy and Menstiuation. THK Role of Water Retention

Cited by 10 publications

References 0 publications

Reproductive hormonal changes and catamenial pattern in adolescent females with epilepsy

Reproductive hormonal changes and catamenial pattern in adolescent females with epilepsy

Epilepsy, Sex Hormones, and Antiepileptic Drugs

Three Patterns of Catamenial Epilepsy

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