Abstracts

RATIONALE:Catamenial Epilepsy is historically defined as recurrent seizures that are correlated with certain phases of a woman's menstrual cycle. Anywhere from 33 - 50% of women with epilepsy report that their seizures fluctuate with their menstrual cycle. Recent studies also report a correlation between menarche and initial onset of seizures. This study is being undertaken to identify those in our patient population who have a catamenial seizure pattern and to determine if this pattern is associated with more refractory seizures. This preliminary data will be used to then stratify patients into particular catamenial patterns (Herzog, et al. 1997). This information may be useful in directing more rational therapy in this patient group. METHODS:A random preliminary survey was performed on 40 of our female patients with refractory seizures. Another 100 surveys have been distributed and are pending. The patients were asked questions regarding menstrual and seizure patterns, and medication history. Their charts were also reviewed. These patients have also agreed to keep a 3 month seizure and menstrual diary to provide more data. RESULTS:Of the 40 patients initially surveyed, 50% reported a catamenial pattern. Of these patients, 10 experienced onset of seizures within 1 year of menarche. Four more patients worsened at the onset of menarche. Eight patients had more seizures premenstrually, 10 patients during menses, and 2 patients at mid-cycle. Partial seizures were the most prevalent in both groups. Mean age and age range were similar for both groups. The catamenial group was taking an average of 2.5 antiepileptic drugs (AEDs), having failed an average of 3 prior AEDs. The other group was on an average of 1.5 AEDs with past failure of an average of 2. CONCLUSIONS:The finding of 50% reported catamenial pattern among our female patients is consistent with the current literature. In this preliminary study we did not find an association between epilepsy type and prevalence of a catamenial pattern. There appears to be a trend in failure of AED therapy and a catamenial pattern.