Variation of seizure frequency with ovulatory status of menstrual cycles.

Authors

• Andrew G Herzog
• Kristen M Fowler
• Michael R Sperling
• Joyce D Liporace
• Laura A Kalayjian
• Christianne N Heck
• Gregory L Krauss
• Barbara A Dworetzky
• Page B Pennell

Publication/Presentation Date

10-1-2011

Abstract

PURPOSE: To determine if seizure frequency differs between anovulatory and ovulatory cycles.

METHODS: The data came from the 3-month baseline phase of an investigation of progesterone therapy for intractable focal onset seizures. Of 462 women who enrolled, 281 completed the 3-month baseline phase and 92 had both anovulatory and ovulatory cycles during the baseline phase. Midluteal progesterone levels ≥5 ng/ml were used to designate cycles as ovulatory. Among the 92 women, average daily seizure frequency (ADSF) for all seizures combined and each type of seizure considered separately (secondary generalized tonic-clonic seizures - 2°GTCS, complex partial seizures - CPS, simple partial seizures - SPS) were compared between anovulatory and ovulatory cycles using paired t-tests. A relationship between the proportional differences in ADSF and estradiol/progesterone (EP) serum level ratios between anovulatory and ovulatory cycles was determined using bivariate correlational analysis.

KEY FINDINGS: ADSF was 29.5% greater for 2°GTCS during anovulatory than during ovulatory cycles. ADSF did not differ significantly for CPS or SPS or for all seizures combined. Proportional differences in anovulatory/ovulatory 2°GTCS ADSF ratios correlated significantly with differences in anovulatory/ovulatory EP ratios. Among the 281 women, the three seizure types did not differ in ovulatory rates, but EP ratios were greater for cycles with 2°GTCS than partial seizures only.

SIGNIFICANCE: Seizure frequency is significantly greater for 2°GTCS, but not CPS or SPS, during anovulatory cycles than ovulatory cycles. Because the proportional increases in 2°GTCS frequency during anovulatory cycles correlate with the proportional increases in EP level ratios, these findings support a possible role for reproductive steroids in 2°GTCS occurrence.

Volume

52

Issue

10

First Page

1843

Last Page

1848

ISSN

1528-1167

Published In/Presented At

Herzog, A. G., Fowler, K. M., Sperling, M. R., Liporace, J. D., Kalayjian, L. A., Heck, C. N., Krauss, G. L., Dworetzky, B. A., Pennell, P. B., & Progesterone Trial Study Group (2011). Variation of seizure frequency with ovulatory status of menstrual cycles. Epilepsia, 52(10), 1843–1848. https://doi.org/10.1111/j.1528-1167.2011.03194.x

Disciplines

Medicine and Health Sciences

PubMedID

21756250

Department(s)

Department of Medicine

Document Type

Article