Epilepsy: what the research says

What hormonal treatments have been tested for PMDD, menstrual migraine, and catamenial epilepsy?

Hormonal treatments have been tested 56 times for premenstrual mood disorder, 21 times for menstrual migraine, and 8 times for catamenial epilepsy. Combined oral contraceptives were a frequent focus.

How do menstrual cycle hormones affect the brain and cause mood disorders like PMDD?

A hormone called allopregnanolone acts on brain receptors. Changes in this hormone during the cycle may cause mood and behavioral symptoms in up to 20% of people through three mechanisms: direct effects, building tolerance, and withdrawal effects.

Do women with epilepsy show different brain patterns during different phases of their menstrual cycle?

Yes. Women with epilepsy showed abnormal changes in brain activity during the perimenstrual phase compared to women without epilepsy, suggesting increased brain excitation during this time.

How can researchers better track hormone changes throughout the menstrual cycle?

Researchers created a new method called PACTS that better tracks how hormones change across your entire menstrual cycle, making patterns easier to spot and potentially improving diagnosis.

Do lithium and valproate levels change during the menstrual cycle?

In women with bipolar disorder, lithium levels decreased during the luteal phase (before the period) despite stable doses, linked to worsening mood symptoms. In healthy women, lithium levels were not affected by the menstrual cycle.

Can neurosteroids help with anxiety and brain disorders?

The review suggests neurosteroids might help with anxiety, epilepsy, and depression, but clinical evidence is limited.

Do women with epilepsy have different hormone patterns or menstrual-related seizures?

Yes. Women with epilepsy had lower levels of certain reproductive hormones compared to healthy women, and about 31% had seizures that relate to their menstrual cycle.

Do common diseases get worse before a woman's period?

Yes. A significant number of women with asthma, arthritis, migraine, diabetes, depression, or epilepsy report that their symptoms get worse before their period, though doctors do not yet fully understand why.

How does the menstrual cycle affect other medical conditions?

Many medical conditions worsen at specific points in the menstrual cycle because of sudden changes in hormone levels. This includes migraines, epilepsy, asthma, arthritis, irritable bowel syndrome, and diabetes.

Do seizures increase during the premenstrual period in women with epilepsy?

Yes. A study of 80 women with epilepsy found significantly more seizures in the premenstrual period (p<0.001) compared to other times of the cycle.

Do seizures in women with epilepsy increase at certain times in the menstrual cycle?

Yes. Women with epilepsy had significantly more seizures during the week before menstruation compared to the week after. In 58% of women, seizures increased during the premenstrual phase.

Does a new way of tracking hormones in research align measurements better across different women?

Yes. The new PACTS method improves how well researchers can align estrogen measurements during the first part of the menstrual cycle, though it works similarly to traditional methods for progesterone during the second part.

Does exam stress make PMS worse?

Yes, exam stress was strongly linked to worse PMS symptoms in medical students (p = 0.004). Students with moderate to high stress had much worse PMS.

What is cyclic menstrual psychosis in adolescents?

This case describes a 14-year-old girl with psychotic symptoms including confusion, delusional ideas and physical restlessness that occurred in a repeating cycle linked to her menstruation. The symptoms went away when her period began.

Can hormonal contraception help women whose psychotic symptoms are linked to their menstrual cycle?

One woman with bipolar disorder and auditory hallucinations that occurred only before her period experienced complete resolution of her hallucinations when switched to a hormonal patch with extended menstrual cycling.

How should healthcare providers manage menstrual problems in girls with disabilities?

Providers should take detailed histories from both the patient and caregivers to understand how menstrual symptoms affect quality of life. Treatment goals should focus on reducing menstrual flow, reducing period pain, and managing cyclical symptoms based on each girl's needs.

How does the menstrual cycle affect mood and seizures in women with epilepsy?

Women with epilepsy experienced mood changes and more seizures during the early follicular phase, not the typical late luteal phase. This suggests they have a different menstrual-related symptom pattern.

Does ovarian cycle stage affect Alzheimer's disease features in female mice?

During estrogen-dominant stages of the cycle, female mice with Alzheimer's features showed worse cognitive problems and brain network dysfunction. During progesterone-dominant stages and after ovary removal, the Alzheimer's features improved.

What menstrual health problems do young women with Angelman syndrome experience?

Menstrual and premenstrual symptoms were common but infrequently caused problems at home or school. Girls with AS had significant challenges with menstrual hygiene and needed full assistance managing it.

Does the hormone drop around the menstrual period change the brain's response to a calming chemical?

In mice, mimicking the hormone drop around the period changed a brain receptor part and made brain cells more sensitive to a calming hormone, affecting seizure risk. This is a mouse study, so it may not work the same way in women.

Could antidepressants help prevent PMS by keeping brain chemicals stable?

This is a theory based on how antidepressants work and animal research, but it has not yet been tested in women.

Do women with epilepsy have more PMDD, and does the medication matter?

Overall, PMDD rates are similar in women with and without epilepsy. But women with certain types of epilepsy, especially temporal lobe epilepsy, have more PMDD, and lamotrigine may reduce the risk.

How do changes in brain chemicals during your cycle affect seizures?

This lab study in mice found that a brain chemical that normally decreases before your period protects against seizures. When it drops, seizures become more likely.

How do the hormones estrogen and progesterone affect the brain's activity, and could this explain PMS or PMDD?

Estrogen tends to make brain cells more excitable, while progesterone and a substance it breaks down into tend to calm them. This balance may help explain PMS and PMDD, but this is a summary of existing research, not a new experiment.

Why do some women experience negative mood with hormone changes?

The paper proposes that negative mood in PMDD may result from how a brain chemical reacts to receptors. This is a theoretical explanation based on research patterns, not a definitive finding from a new study.

Does having epilepsy increase the risk of PMDD, and what makes it worse?

The study suggests epilepsy and certain antiepileptic drugs may influence PMDD severity in women with epilepsy, but findings are preliminary. Specific medications like carbamazepine and lamotrigine appear to affect PMDD differently.

How do brain structures called GABA receptors relate to different health problems?

This review describes how changes in GABA receptors might be connected to various health problems. This is theoretical background information, not a study of actual patients, so it cannot tell us whether GABA receptors cause specific conditions.

Does a hormone called allopregnanolone calm the body's startle reaction in PMDD?

No. Giving this hormone by injection made women feel more sedated but did not change their physical startle response, in either women with PMDD or healthy women.

Does levetiracetam help treat PMDD?

In a small pilot study, 6 out of 7 women with PMDD had their symptoms improve considerably with levetiracetam over 4 months. Because there was no control group, we cannot be sure the improvement was due to the drug rather than other factors.

Do women with seizures that worsen around their period have different hormone levels?

Yes. Women whose seizures get worse before their period have lower THDOC levels and a lower DHEAS/cortisol ratio throughout their cycle (p < 0.05), which might explain their worsening seizures.

How do hormones change the brain in PMDD and menstrual-related seizures?

Sex hormones like estrogen and progesterone affect brain chemicals that control mood and seizure activity. These effects may explain why both PMDD and menstrual-related seizures worsen around the menstrual cycle, suggesting similar treatments might help both conditions.

What is catamenial epilepsy and how can it be treated?

Catamenial epilepsy is when seizures cluster around specific times in the menstrual cycle, affecting at least one in three women with epilepsy. Progesterone or neurosteroid drugs may help.

Can drospirenone birth control help severe PMS with brain swelling and seizures?

In one woman with severe PMS including brain swelling and seizures, treatment with an oral contraceptive containing drospirenone significantly reduced all symptoms and prevented the brain swelling and seizures.

How do changes in brain chemistry during the menstrual cycle affect anxiety and seizures?

During the high-progesterone phase of the cycle, specific brain chemicals increase the brain's ability to calm down, which reduces seizure risk and anxiety. Some women with PMDD or epilepsy may not have normal cycling of these chemicals, which could explain their symptoms.

Does the menstrual cycle affect seizures in women with epilepsy?

This review says many women with epilepsy notice their seizures change with their menstrual cycle, likely because hormones affect the brain, but it does not give a firm answer on how to treat this.

Do common health conditions get worse at certain times in your menstrual cycle?

Yes. Migraine, epilepsy, asthma, irritable bowel syndrome (IBS), and diabetes can worsen at certain points in the menstrual cycle.

How do steroid hormones affect the brain and cause symptoms?

Steroid hormones can rapidly change brain activity and behavior within seconds to minutes. This review discusses these fast effects in relation to premenstrual syndrome and other conditions.

Does withdrawal of a progesterone metabolite increase seizure risk around menstruation?

In rats, withdrawal of allopregnanolone (a progesterone metabolite) increased how easily seizures happen, supporting the theory that this withdrawal contributes to increased seizures during menstruation in women with epilepsy.

Can progesterone help reduce seizures that get worse before menstruation?

In one woman with epilepsy whose seizures worsened before her period, progesterone restored normal brain activity patterns, suggesting it may help control seizure-related brain changes during the menstrual cycle.

Why do women get more anxious when hormone levels drop?

Falling estrogen and progesterone levels may trigger anxiety and mood disorders by affecting how brain receptors that control anxiety and mood work. The exact mechanism is not yet fully understood.

Do brain-like experiences increase when geomagnetic activity is high in women with PMS?

In this very small study, 5 out of 12 women (41%) showed increases in complex partial epileptic-like experiences when geomagnetic activity was high. However, the sample is too small to be confident about this finding.

How does progesterone dropping affect the brain's anxiety-control system?

When progesterone suddenly drops, the brain's anxiety-calming system becomes much less effective. This might explain anxiety symptoms that some women experience before their period.

What does research say about diagnosing and treating PMS and PMDD?

This review explains that careful symptom tracking and ruling out other conditions are key to diagnosing PMS, and that some promising drug treatments exist for PMDD, though it is unclear if they work as well for milder premenstrual symptoms.

Can antidepressant and anti-epilepsy medications help premenstrual dysphoria?

Yes, it appeared to help. Women with premenstrual dysphoria responded well to a combination of antidepressant and anti-epilepsy medications. Most participants had epilepsy, so we need to test this in women without epilepsy to be sure.

Do hormone changes around menstruation cause seizures in women with epilepsy?

Yes. In 5 women with epilepsy, seizures happened around their period due to hormone changes. Low progesterone and high estrogen triggered seizures in 4 women. In 1 woman, lack of ovulation was the cause.

Do sleep patterns change during the menstrual cycle?

Yes, some sleep patterns change during the cycle. Women wake up later in the late luteal phase, and they get more deep sleep in the follicular phase. Other sleep measures seemed to change but the differences were not clear.

How common is seizure worsening with the menstrual cycle in women with epilepsy?

Only 12.5% of women met the strict definition of seizures worsening with menstruation. However, 78% of women reported afterward that their seizures got worse during their period, showing that women's memories may not match their actual tracking.

Does low-dose valproate help premenstrual syndrome?

In this small trial, only 3 of 8 women with premenstrual syndrome (38%) reported good response to low-dose valproate, while 5 reported no response. The medication worked much better for mood disorders than for PMS.

Do women with menstrually-related migraine have different hormone levels than women with epilepsy?

Yes, women with menstrually-related migraine had lower progesterone and estradiol levels than women with epilepsy. Their endorphin levels near menstruation showed a different pattern than the epilepsy group.

Do women with cycle-related seizures have different hormone levels?

Women whose seizures are linked to the premenstrual phase had notably lower levels of a hormone called LH on certain days of their menstrual cycle compared to women whose seizures are not cycle-related.

Does brain electrical activity change from midcycle to the premenstrual phase?

Yes. Significant changes occur in brain electrical activity during the premenstrual phase in most women. These might explain mood changes and seizure risk during menstruation.

Are hormone levels different in women with seizures that occur before their period?

Yes, women with seizures before menstruation had significantly lower levels of a hormone called 17-KS. Researchers think this may play a role in premenstrual seizures, but the results are not yet conclusive.

Are estrogen and progesterone levels different in women with seizures that occur before their period?

Yes, women with seizures before menstruation had significantly lower levels of progesterone metabolites, especially on days 1-2 before bleeding. Researchers suggest this may increase seizure risk, but the study is too small to be definitive.

Can hoarseness be a symptom of PMS?

This clinical report describes hoarseness and loss of vocal control as symptoms of premenstrual tension, though the cause is not yet understood.