Catamenial epilepsy: Update on prevalence, pathophysiology and treatment from the findings of the NIH Progesterone Treatment Trial

Seizure : the Journal of the British Epilepsy Association
Andrew G Herzog

Abstract

To extend our knowledge and practical application of the concept of catamenial epilepsy. The review focuses on the impact of the NIH Progesterone Trial on our understanding of the pathophysiology and treatment of catamenial epilepsy. Catamenial epilepsy refers to the cyclic exacerbation of seizures in relation to the menstrual cycle. An interaction between seizures and the menstrual cycle is suggested by variations in seizure frequency according to the day, phase and ovulatory status of the menstrual cycle. There are three commonly recognized patterns: perimenstrual (C1: Day -3 to +3), peri-ovulatory (C2: Day 10 to 3) and entire luteal phase in anovulatory cycles (C3: Day 10 to 3). Pathophysiological determinants include 1) the neuroactive properties of reproductive steroids, 2) the variation of neuroactive steroid levels across the menstrual cycle and 3) the differential susceptibility of epileptic substrates to neuroactive steroid effects. Perimenstrual seizure exacerbation may result from the premenstrual withdrawal of progesterone which is accompanied by withdrawal of allopregnanolone, a potent positive allosteric modulator of the GABAA receptor, and changes in the subunit composition of the GABAA receptor to the α4 subtype...Continue Reading

References

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Citations

Apr 19, 2016·Neurologic Clinics·Naymeé J Vélez-Ruiz, Page B Pennell
Mar 15, 2015·Seizure : the Journal of the British Epilepsy Association·Erik TaubøllSigrid Svalheim
May 10, 2016·Trends in Pharmacological Sciences·Doodipala Samba Reddy, William A Estes
May 18, 2016·Current Treatment Options in Neurology·Allison Navis, Cynthia Harden
Jul 15, 2016·Postgraduate Medical Journal·Inuka Kishara Gooneratne, Sunil Wimalaratna
Jul 14, 2018·Journal of Neurochemistry·Stefano MelettiGiuseppe Biagini
Feb 25, 2020·Annals of the New York Academy of Sciences·Meghan GageThimmasettappa Thippeswamy
Apr 4, 2020·Annals of Clinical and Translational Neurology·Suchitra JoshiLaura A Jansen
Aug 2, 2020·Epilepsia·Vikram R RaoMaxime O Baud
Mar 17, 2017·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Irene ChuahKatharine Steinbeck
Jan 10, 2018·Nature Communications·Maxime O BaudVikram R Rao
Oct 9, 2020·Journal of Clinical Neurology·Jon Soo KimWon Seop Kim
Jan 3, 2021·Pediatrics in Review·Diana BordaloTeresa Temudo
Oct 30, 2020·Frontiers in Endocrinology·Barbara MiziakStanisław J Czuczwar
Feb 4, 2021·Clinical Neurophysiology Practice·Maxime O BaudVikram R Rao
Dec 25, 2017·Neurobiology of Disease·Suchitra JoshiJaideep Kapur
Mar 17, 2021·Nature Reviews. Neurology·Philippa J KarolyMaxime O Baud
Jun 25, 2021·Epilepsia·Shinnosuke ShionoSuchitra Joshi
Aug 24, 2021·Frontiers in Neurology·Philippa J KarolyEwan S Nurse
Sep 11, 2018·Seizure : the Journal of the British Epilepsy Association·Barbara MostacciPaolo Tinuper

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