Advanced Biomedical Research

Progesterone therapy in women with intractable catamenial epilepsy

Authors

1 Department of Neurology, Isfahan Neuroscience Research Center, Isfahan, Iran

2 Epidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Catamenial epilepsy is a kind of epilepsy, known in this name, when the periodicity of the exacerbation of the seizure is in association with menstural cycle. The present study examined the progesterone effectiveness as a complementary treatment in women with intractable catamenial epilepsy.
Materials and Methods: The present study was conducted as a double-blind randomized controlled trial on 38 women with intractable catamenial epilepsy. Patients were assessed in two groups: The case group received in addition to AEDs, two (Mejestrol) 40 mg progesterone tablets in the second half of the cycle from 15 th to 25 th day. And the control group received in addition to AEDs, two placebo tablets daily. Age, BMI, epilepsy duration, types of the drugs used, progesterone level, and the number of the seizures in 3 months before and after the study were compared.
Results: Based on the results of which there was no statistically significant difference in regard to age, BMI, epilepsy duration, types of the drugs used, progesterone level between the case and the control groups (P-value > 0.05). The number of the seizures after treatment has significantly decreased compared to before-treatment state. The degree of decreasing in the case group receiving the progesterone was higher than in the control group receiving the placebo. The difference, thus, is significant, based on statistical tests (P-value = 0.024).
Conclusion: Based on the findings of this study using progesterone in women with intractable catamenial epilepsy has a significant effect on the degree of decreasing in the number of the seizures.

Keywords

1. Tauboll E, Luef G. Gender issues in epilepsy-the science of why it is special. Seizure 2008;17:99-100.  Back to cited text no. 1
    
2. Herzog AG. Catamenial epilepsy: Definition, prevalence pathophysiology and treatment. Seizure 2008;17:151-9.  Back to cited text no. 2
    
3. Tauboll E, Lundervold A, Gjerstad L. Temporal distribution of seizures in epilepsy. Epilepsy Res 1991;8:153-65.  Back to cited text no. 3
    
4. Fowler K, Massaro J, Harden C, Liporace J, Pennell P, Schomer D, et al. Distribution of seizure occurrence in women with epilepsy: Preliminary sata analysis in a prospective multicenter investigation. Epilepsia 2006;47:1.  Back to cited text no. 4
    
5. Herzog AG, Klein P, Ransil BJ. Three patterns of catamenial epilepsy. Epilepsia 1997;38:1082-8.  Back to cited text no. 5
    
6. El-Khayat HA, Soliman NA, Tomoum HY, Omran MA, El-Wakad AS, Shatla RH. Reproductive hormonal changes and catamenial pattern in adolescent females with epilepsy. Epilepsia 2008;49:1619-26.  Back to cited text no. 6
    
7. Herzog AG, Harden CL, Liporace J, Pennell P, Schomer DL, Sperling M, et al. Frequency of catamenial seizure exacerbation in women with localization-related epilepsy. Ann Neurol 2004;56:431-4.  Back to cited text no. 7
    
8. Bazan AC, Montenegro MA, Cendes F, Min LL, Guerreiro CA. Menstrual cycle worsening of epileptic seizures in women with symptomatic focal epilepsy. Arg Neuropsiguiatr 2005;63:751-6.  Back to cited text no. 8
    
9. Kaplan PW, Norwitz ER, Ben Menachem E, Pennell PB, Druzin M, Robinson JN, et al. Obstetric risks for women with epilepsy during pregnancy. Epilepsy Behav 2007;11:283-91.  Back to cited text no. 9
    
10. Pennel PB. Antiepileptic drugs during pregnancy: What is known and which AEDs seem to be safest? Epilepsia 2008;49(Suppl 9):43-55.  Back to cited text no. 10
    
11. Herzog AG. Hormonal therapies: Progesterone. Neurotherapeutics 2009;6:383-91.  Back to cited text no. 11
    
12. Smith SS. Estradiol administration increases neuronal responses to excitatory amino acid as a long- term effect. Brain Res 1989;503:354-7.  Back to cited text no. 12
    
13. Herzog AG. Progesteron in seizure therapy [reply to letter]. Neurology 1987;37:1433.  Back to cited text no. 13
    
14. Backstom T. Epileptic seizures in women related to plasma estrogen and progesterone during the menstrual cycle. ActaNeurolScand 1976;54:321-47.  Back to cited text no. 14
    
15. Herzog AG. Reproductive endocrine considerations and hormonal therapy for women with epilepsy. Epilepsia 1991;32:27-S33.  Back to cited text no. 15
    
16. Laidlaw J. Catamenial epilepsy. Lancet 1956;271:1235-7.  Back to cited text no. 16
    
17. Backstom T. Epileptic seizures in women related to plasma estrogen and progesterone during the menstrual cycle. ActaNeurolScand 1976;54:321-47.  Back to cited text no. 17
    
18. Mattson RH, Kamer JA, Caldwell BV, Cramer JA. Seizure frequency and the menstrual cycle: A clinical study [abstract]. Epilepsia 1981;22:242.  Back to cited text no. 18
    
19. Herzog AG, Seibel MM, Schomer DL, Vaitukaitis JL, Geschwind N. Reproductive endocrine disorders in women with partial seizures of temporal lobe origin. Arch Neurol 1986;34:341-346.  Back to cited text no. 19
    
20. Jones GS. The luteal phase defect. Fertil Steril 1976;27:351-3546.  Back to cited text no. 20
    
21. Herzog AG. Intermittent progesterone therapy and frequency of complex partial seizures in women with menstrual disorders. Neurology 1986;36:1067-610.  Back to cited text no. 21
    
22. Reddy DS. The role of neurosteroids in the pathophysiology and treatment of catamenial epilepsy. Epilepsy Res 2009;85:1-30.  Back to cited text no. 22
    
23. Duncan S, Read CL, Brodie MJ. How common is catamenial epilepsy? Epilepsia 1993;34:827-31.  Back to cited text no. 23
    
24. Herzog AG. Disorders of reproduction in patients with epilepsy: Primary neurological mechanisms. Seizure 2008;17:101-10.  Back to cited text no. 24
    
25. Morrell MJ, Montouris GD. Reproductive disturbances in patients with epilepsy. Cleve Clin J Med 2004;71:S19-24.  Back to cited text no. 25
    
26. Najafi MR, Sonbolestan F, Sonbolestan SA, Zare M, Mehvari J, Meshkati SN. The course and outcome of pregnancy and neonatal situation in epileptic women. Adv Biomed Res 2012;1:4.  Back to cited text no. 26
  Medknow Journal  
27. Tuveri A, Paoletti AM, Orrù M, Melis GB, Marotto MF, Zedda P, et al. Reduced serum level of THDOC, an anticonvulsant steroid, in women with perimenstrual catamenial epilepsy. Epilepsia 2008;49:1221-9.  Back to cited text no. 27
    
28. Bonuccelli U, Melis GB, Paoletti AM, Fioretti P, Murri L, Muratorio A. Unbalanced progesterone and estradiol secretion in catamenial epilepsy. Epilepsy Res 1989;3:100-6.  Back to cited text no. 28
    
29. Herzog AG, Friedman MN, Freund S, Pascual-Leone A. Transcranial magnetic stimulation evidence of a potential role for progesterone in the modulation of premenstrual corticocortical inhibition in a woman with catamenial seizure exacerbation. Epilepsy Behav 2001;2:367-9.  Back to cited text no. 29
    
30. Guille C, Spencer S, Cavus I, Epperson CN. The role of sex steroids in catamenial epilepsy and premenstrual dysphoric disorder: Implications for diagnosis and treatment. Epilepsy Behav 2008;13:12-24.  Back to cited text no. 30
    
31. Herzog AG. Intermittent progesterone therapy of partial complex seizures in women with menstrual disorders. Neurology 1986;36:1607-10.  Back to cited text no. 31
    
32. Herzog AG. Progesterone therapy in women with complex partial and secondary generalized seizures. Neurology 1995;45:1600-62.  Back to cited text no. 32
    
33. Herzog AG. Progesterone therapy in women with epilepsy: A 3-year follow-up. Neurology 1999;52:1917-8.  Back to cited text no. 33
    
Advanced Biomedical Research
Volume 2013, March
March 2013
Pages 1-6