Foldvary-Schaefer and Falcone listed criteria for catamenial ("monthly") epilepsy in women, which involves seizures occurring in association with the time of a woman's menstrual cycle. Up to a third of women with epilepsy may have catamenial features.


Features of catamenial epilepsy:

(1) The patient is a woman.

(2) The occurrence of seizures varies with the different phases in the woman's menstrual cycle.

(3) The risk of seizures may be decreased during an anovulatory cycle.

(4) In theory steps taken to reduce the hormonal surges may reduce the frequency of seizures.


Herzog et al noticed 3 patterns for occurrence during the menstrual cycle:

(1) perimenstrual (around the time of menses)

(2) periovulatory (midcyle, around the time of ovulation)

(3) luteal (from late proliferative to menstrual phase, during period of elevated serum progesterone)

Some women will show an increase in seizures during both the periovulatory and perimenstrual periods.


One factor affecting the number of women diagnosed with the condition is the cutoff for seizure frequency during the period. This varies with different authors. One definition is a frequency at least 2 times greater than that seen in the midfollicular phase.


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