Two women in business attire laughing

Chalisserya AJ, Murphy E, Mullins G, Widdess-Walsh P, Kilbride R, Delantya N. Epilepsy & Behavior 9 (2018): 19-21

Purpose

Catamenial epilepsy is a term used to refer to seizures or the worsening of seizures related to the menstrual cycle in women with epilepsy. According to other studies, one-third of women with drug-resistant focal epilepsy had a two-fold increase in average daily seizure frequency during their menstrual cycles. However, the incidence of catamenial status epilepticus (when seizures follow one another without recovery in between) is unknown.

Description of Study

  • The study presents two individuals from the Beaumont Hospital in Dublin, Ireland, who had catamenial status epilepticus (SE).
  • The first individual was a 33-year-old female with a history of genetic generalized epilepsy. She presented with repeated periods of unresponsiveness after an episode. She would also have “up to six convulsive seizures occurring on day 1 of her menstrual cycle.”
  • The second individual was a 22-year-old with cystic fibrosis. She had been seizure free on carbamazepine monotherapy until she was 21. At that time, she presented with focal non-lesional frontal lobe epilepsy. Although her menstrual cycles were irregular, her episodes of SE would occur at the time of menstruation. These episodes would lead to her admittance to the intensive care unit four times because of respiratory failure.

Summary of Study Findings

  • The first woman became seizure free using a new combination of medications, including zonisamide, lacosamide, and regular clobazam. She was doing well at her six-month follow-up.
  • The second woman unsuccesfully tried multiple anti-seizure drugs and a hormonal treatment using an intrauterine device (IUD). She was also provided with triptorelin. Triptorelin is an effective suppressor of estrogen and makes the ovaries no longer function. This treatment allowed her to remain seizure free (her last follow-up was one year ago). She has not needed further hospitalization.

What Does This Mean?

  • Epilepsy is a complex condition that can present in unique ways and affect each person differently.
  • These two cases are examples of reoccurring catamenial status epilepticus. Their experiences can contribute to the literature regarding this condition. Treatments aren’t well defined as the first person was able to become seizure free with anti-seizure drugs and the second with a hormone therapy using triptorelin.
  • The authors claim catamenial status epilepticus is rare. The title of the paper suggests the authors recommend tracking this condition to find out how rare it is.

Article published in Epilepsy & Behavior, October 2017.

we recommend
Authored By: 
Dara Farhadi MS
Authored Date: 
05/2018
Reviewed By: 
Joseph I. Sirven MD
on: 
Tuesday, May 22, 2018