Effect of Menarche on Seizure Burden in Patients with Lennox-Gastaut Syndrome
Abstract number :
2.281
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2025
Submission ID :
293
Source :
www.aesnet.org
Presentation date :
12/7/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Jill Nulle, MD – University of Michigan
Louis Dang, MD, PhD – University of Michigan
Laurel Reed, MD – University of Michigan
Daniel Kashima, MD, PhD – University of Michigan
Harlan McCaffery, MS – University of Michigan
Rationale: Hormones such as estrogen and progesterone are known to influence seizure thresholds, leading to catamenial epilepsy in a subset of women with epilepsy. While prior studies assessing the correlation between menarche and seizure onset have found mixed results, little is known about the effects of puberty on seizure burden in patients with a specific diagnosis, such as Lennox-Gastaut syndrome (LGS). Determining whether seizure burden in LGS is affected by pubertal changes such as menarche would inform prognosis and anticipatory guidance for caregivers of patients with LGS.
Methods: A retrospective chart review of female patient with LGS who had a documented age of menarche and who had been evaluated at Mott Children’s Hospital between 2013-2023 was performed. Menarche was used as a proxy for puberty. Seizure type, frequency, number of anti-seizure medications, and change in anti-seizure medications was recorded yearly between the ages of 5-21. Statistical analysis with cumulative logit mixed models was used to estimate the odds of a patient having higher seizure frequency by seizure type. A linear mixed model was used to assess change in antiseizure medications.
Results: A total of 22 patients met inclusion criteria. Menarche was statistically significantly associated with increased overall seizure frequency (OR 1.67, p=0.04), but when controlling for age, no longer reached statistical significance (OR 0.58, p=0.195). However, age was positively associated with seizure frequency (OR 1.16 per year, p=0.002). When controlling for age, most individual seizure types (nonmotor, atonic, tonic, myoclonic, clonic, status epilepticus) did not significantly increase with menarche, except for generalized tonic-clonic seizures (OR 1.03, p=0.001), though the clinical significance of this is small. Total number of antiseizure medications (ASMs) used significantly increased after menarche by an estimated 0.43 ASMs (p=0.026), when controlling for age. When controlling for menarche, total number of ASMs also increased with age by an estimated 0.08 ASMs per year (p< 0.0001).
Clinical Epilepsy