Catamenial Epilepsy

By: Mugdha Dip

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What is Catamenial Epilepsy?

Catamenial Epilepsy can be described as menstrual seizures that are linked with women’s menstrual cycle and hormone levels in the body. It is found that at least three patterns of catamenial seizure occur. The pattern includes perimenstrual, periovulatory in ovulatory processes, and the entire luteal phase in anovulatory cycles (Herzog, 2007).  A mathematical basis for catamenial epilepsy was developed that states one-third of women experience catamenial epilepsy (Herzog, 2007). About 1.7 million women have epilepsy in the United States, and CE affects about 40 percent of women with epilepsy (Frank and Tyson, 2020).

Can women experience epilepsy during pregnancy?

According to the article, Catamenial epilepsy: Definition, prevalence pathophysiology, and Treatment, pregnancy may have some effects on epilepsy. A small number of women can experience epilepsy that only occurs during pregnancy (Herzog, 2007). It was found that seizure frequency decreases in about one-sixth of women because patients were using antiseizure medication during pregnancy (Herzog, 2007).

What causes Catamenial Epilepsy?

Catamenial epilepsy is a subset of seizures affected by menstrual fluctuations that include progesterone and estrogen (Frank and Tyson, 2020). Estrogen is found to have profound effects on the brain. On the other hand, increased progesterone levels helped decrease seizure occurrence in the brain (Frank and Tyson, 2020). In human models, participants who received progesterone injection had a reduction in the frequency of seizures in 4 of 7 women (Frank and Tyson, 2020).

How is Catamenial Epilepsy diagnosed?

According to the article, A Clinical Approach to Catamenial Epilepsy, Catamenial epilepsy is diagnosed when no other explanation of seizure patterns can be established. Diagnoses are also made by making patients make charts of their menstrual cycle and seizure activity. By tracking the menstrual cycle, clinicians can identify the relationship between hormonal fluctuations and their impact on seizure activity to make a correct diagnosis. According to Cedars Sinai, one of the most practical tests is an electroencephalogram (EEG) that shows electrical activity in the brain to evaluate unusual activity patterns. An MRI and CT scans can also be helpful when studying catamenial epilepsy conditions.

What are the symptoms of Catamenial Epilepsy?

The symptoms of catamenial epilepsy include dizziness, confusion, changes in emotions, and changes in feelings (Cedars Sinai). Many patients experience more symptoms than others because it depends if a person is having a partial seizure or generalized seizure (Cedars Sinai).

What are the treatment options?

The treatment options are trying to prevent seizures at all costs. The treatment options include anti-seizure drugs and natural progesterone to control seizures (Frank and Tyson, 2020). The benefit of natural progesterone is that it can reduce the frequency of seizures in women in a short amount of time (Frank and Tyson, 2020). Oral contraceptives, which are birth control pills, are also given to help lower estrogen in the body (Cedars Sinai).


Catamenial Epilepsy. Cedars Sinai. (n.d.). Retrieved May 25, 2022, from



Frank, S., & Tyson, N. A. (2020). A Clinical Approach to Catamenial Epilepsy: A Review. The

Permanente Journal, 24, 1–3.

Herzog, A. G. (2008). Catamenial epilepsy: Definition, prevalence pathophysiology, and

treatment. Seizure, 17(2), 151–159.

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