Abstracts

Rationale: Catamenial epilepsy refers to seizure clustering around specific points in the menstrual cycle. While some studies support the existence of catamenial epilepsy, other studies have found no patterns of seizures related to the menstrual cycle. Here we compare a patient with presumed catamenial epilepsy to 4 others without.

Methods: In a prospective case series, the seizure diaries of five participants enrolled in a seizure forecasting study were analyzed. In one participant believing she had catamenial epilepsy (patient 1), her menstrual calendar was analyzed, with the onset of menstruation indicating day 1 of the presumed 28-day cycle. In the other four (two females, two males) participants, 28-day cycles were created using the start of their enrollment date in the study. Phases of the hormone cycle were treated in the standard fashion according to Herzog et al 1997. Histograms of all five patients were created to analyze the presence of cyclical patterns using ANOVA.

Results: There was no statistically significant difference between the four phases of the hormone cycle in patient 1 (p=0.09). There was also no statistically significant difference between the four phases of the hormone cycle in patient 2 (p=0.29), patient 3 (p=0.44), patient 4 (p=0.68), and patient 5 (p=0.29). Of note, patient 1 was not seizure free (on average) any day in her cycle, and therefore not risk free during any day or even any phase.

Conclusions: The patient with presumed catamenial epilepsy did not show a partially cyclical pattern in relation to her hormone cycle. It is beneficial to analyze multiple hormone cycles with a comprehensive statistical test to determine if a patient truly has a catamenial pattern. Without sufficient cycles, one may mis-classify patients with catamenial epilepsy.

Funding: Supported in part by NIH NINDS KL2 5KL 2TR002542