Diagnosis and management of catamenial seizures: a review

Alberto Verrotti,¹ Claudia D’Egidio,¹ Sergio Agostinelli,¹ Carla Verrotti,² Piero Pavone<sup>3

1</sup>Department of Paediatrics, University of Chieti, ²Department of Obstetrics and Gynecology, University of Parma, ³Unit of Paediatrics, University Hospital “Vittorio Emanuele”, Catania, Italy

Abstract: Catamenial epilepsy is defined as a pattern of seizures that changes in severity during particular phases of the menstrual cycle, wherein estrogens are proconvulsant, increasing the neuronal excitability; and progesterone is anticonvulsant, enhancing GABA-mediated inhibition. Thus, changes in serum estradiol/progesterone ratio throughout a normal reproductive cycle bring about an increased or decreased risk of seizure occurrence. To date, there are no specific drug treatments for catamenial epilepsy however, non-hormonal and hormonal therapies have been proposed. The aim of this review is to report preclinical and clinical evidences about the relationship between female reproductive steroids and epileptic seizures, and to describe treatment approaches for catamenial epilepsy.

Keywords: catamenial epilepsy, estrogens, progesterone, neurosteroids