Clinical and neurological study of women with precatamenial epilepsy

To describe clinical features and seizure dispersion in precatamenial/pericatamenial epilepsy patients.

Case series.

Department of Neurology (formerly Neuropsychiatry), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from July 1991 to November 2001.

Present study included 33 untreated pericatamenial (n: 23, age: 12-40 years, menstrual cycles: 147) and precatamenial (n: 10, age: 13-32 years, menstrual cycles: 70) epileptics with tonic-clonic seizures. Clinical features and seizure dispersion were evaluated during premenstruation, menstruation, and postmenstruation phases.

Women with precatamenial epilepsy had highly significant mean phase day seizures during premenstruation versus other phases, whereas women with pericatamenial epilepsy did not show any significant variations. Premenstrual seizures were found significantly more and others as significantly less in % number in precatamenials compared to those in pericatamenials. Furthermore, precatamenial epileptics with primary generalized seizures were significantly higher in % number and secondary generalized seizures as significantly lower against those in pericatamenial epileptics. All precatamenial epileptics under study had incontinence compared to 65% pericatamenial epileptics that had incontinence. Majority of the patients in both groups showed post-ictal headache.

The present report describes the extent of exacerbation of premenstrual tonic-clonic seizures with clinical features. These investigations may help in understanding partly the complexity of catamenial/precatamenial/ pericatamenial/noncatamenial seizures, and similarities and dissimilarities between pericatamenial and precise precatamenial seizures.