Catamenial epilepsy occurence and patterns in a mixed population of women with epilepsy.

Abstract

We aimed to evaluate the occurrence and distribution of patterns of catamenial epilepsy in a heterogenous cohort of women with epilepsy on no hormonal therapies, enrolled in a prospective, observational study. The primary aim of the study was pregnancy rate in women with epilepsy with no prior reproductive problems. In this analysis, we included women who recorded ≥one menstrual cycle with ≥one seizure. We measured progesterone concentrations for 1-3 cycles. We defined catamenial patterns as ≥two-fold average daily seizure frequency around menstruation (C1), ovulation (C2) and, for anovulatory cycles, from mid-cycle through menstruation (C3). Twenty-three of the 89 enrolled women with epilepsy were eligible for this analysis: 12/23 met criteria for catamenial epilepsy, and 5/23 demonstrated only a C1 pattern, 2/23 only a C2 pattern, 5/23 a combined C1/C2 pattern, and 0/1 women with anovulatory cycles demonstrated a C3 pattern. There were no differences in likelihood of demonstrating a catamenial pattern between those who reported a prior catamenial pattern and those who did not (p=0.855). This analysis demonstrates the utility of app-based tracking to determine a catamenial pattern. Larger prospective studies could confirm these findings and inform potential therapeutic trial designs for catamenial epilepsy.