Abstracts

RATIONALE: Female patients commonly report that seizures and other episodic medical conditions worsen peri-menstrually. Young females near menarche or with primary or secondary amennorhea may still experience cyclic exacerbations of seizures. It is well-established in the gynecologic literature that synchronization of menstrual cycles of females living in close quarters also commonly occurs. We sought to identify households in which amennorheic females exhibited seizure exacerbations coincident with menstrual cycles of other female household members.
METHODS: We identified seven amennorheic or perimenarchal females with epilepsy who lived with another female with active, fairly regular menstrual cycles. We compared seizure calendars and menstrual calendars retrospectively over 3 months. Patient records were reviewed to determine seizure type, antiepilepsy treatment, and amennorhea history.
RESULTS: Two patients exhibited consistent seizure exacerbations during the female household member[ssquote]s menses for 2 of 3 cycles. One patient had a seizure exacerbation during only one cycle. In two cases, both females slept in the same room. Of the remaining four patients, one had no seizures during the time period reviewed, and the other three had no clear pattern to seizure occurrence. None of the unsynchronized female pairs slept in the same room. There was no specific association with seizure type or medication and synchronization. Only one of two perimenarchal females exhibited synchronization.
CONCLUSIONS: Synchronization of hormonal patterns between females can result in an exacerbation of seizures in a female with no obvious menstrual cycling. We conclude that especially in cases where seizure calendars suggest cyclic clusters, review of menstrual cycles of both patient and close female contacts is useful. Further study is needed to determie if pharmacologic hormonal manipulation or change in living arrangements can affect seizure patterns.