Pro-inflammatory cytokine activity: The root cause of catamenial seizures

Abstract

About 40% of women with epilepsy experience catamenial seizures, which can be mentally and physically debilitating. Catamenial epilepsy (CE) refers to the relationship between the timing of a woman’s seizures and the monthly hormonal changes that occur throughout her menstrual cycle. The prevailing hypothesis theorizes that these hormonal changes cause CE seizures. However, researchers have not isolated the catamenial seizure neurological trigger mechanism; as a result, standard anti-seizure medications (ASMs) mostly are ineffective. Recent research substantiates the significant role inflammatory cytokines play in epilepsy, menstrual disorders, and the female reproductive system. This paper poses a new hypothesis that the direct trigger of catamenial seizures is an increase in pro-inflammatory cytokines that occurs at several times during the menstrual cycle. The hypothesis is evaluated using published evidence that the occurrences of catamenial seizures during the menstrual cycle align temporally with the surges in pro-inflammatory cytokines. Consequently, the anti-inflammatory benefits of exercise, endocannabinoid-based drugs and safe, neuroprotective dietary supplements could enable hundreds of thousands of women with catamenial epilepsy to enjoy more productive lives from a much reduced risk of seizures.