SEIZURE OCCURRENCE DURING OVULATORY AND ANOVULATORY CYCLES IN PATIENTS WITH TEMPORAL-LOBE EPILEPSY - A PROSPECTIVE-STUDY

We investigated the influence of ovulatory and anovulatory menstrual c ycles on seizure occurrence in female patients with complex partial se izures. We prospectively documented seizures in relation to menstrual cycles (defined by measurement of basal body temperature and progester one serum concentrations) in 39 female patients. One hundred and thirt y-two cycles of 35 patients entered final analysis. Only eight patient s had anovulatory cycles, in 18 patients all cycles were ovulatory. In the remaining nine patients anovulatory as well as ovulatory cycles w ere documented. In ovulatory cycles the mean frequency of seizures dur ing the days of menstruation was significantly higher as compared to t he periovulatory or the luteal phase of the cycles. During anovulatory cycles seizure frequency was significantly lower during menstruation than in the remaining days of the cycles. Since progesterone is known to exhibit anticonvulsant effects, seizure occurrence during menstruat ion seems to be related to ovulatory cycles, possibly due to the preme nstrual decrease of progesterone. Therapeutic recommendations for the treatment of seizures related to the menstrual cycle (catamenial seizu res) include the administration of hormones, as progesterone (recommen ded especially for women with catamenial epilepsy who have a documente d inadequate luteal phase) or the suppression of the menstrual hormona l cycle by synthetic gonadotropin releasing hormone analogs.