n its purest form, a woman with catamenial epilepsy may have seizures only at the time of menstruation, but this form is not very common.
More typically, the woman may tend to have more seizures at particular times during her menstrual cycle, usually just before or during the onset of menstruation or at the time of ovulation.Four patterns of catamenial seizure exacerbation may be observed:
perimenstrual ovulation throughout the second half of the menstrual cycle menopause
Seizure exacerbation around the time of menstruation or ovulation occurs in women with normal or irregular menstrual cycles.
Women with abnormal menstrual cycles may have exacerbation in the second half (luteal phase) of the cycle. This pattern is the most difficult one to distinguish because the time of seizure exacerbation is prolonged rather than focused. These women have anovulatory cycles and inadequate luteal phase. Because they do not ovulate, no corpus luteum (derived from the egg leaving the ovary) is formed during the second (luteal) half of the menstrual cycle and no progesterone is secreted.
Causes of Catamenial Epilepsy
Menstrually related hormonal fluctuations in estrogen and progesterone underlie the patterns of catamenial seizure exacerbation. Estrogens facilitate seizures, whereas progesterone protects against seizures. During the menstrual cycle, serum levels of estradiol and progesterone flucate.