Catamenial Epilepsy: The Menstrual Cycle as a Clue to Predict Future Refractory Seizures

Catamenial epilepsy is defined as an increase in the frequency of seizures during a particular phase of the menstrual cycle. The increased seizure frequency is attributed to the cyclic variation and neuroactive properties of endogenous steroid hormones. It is estimated that more than one-third of women with epilepsy experience catamenial seizure exacerbation.

We present the case of a young female patient who presented to the emergency department with an increase in seizure frequency that coincided with her menstrual cycle, despite complete medication compliance. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: It is important for the emergency physician to consider catamenial epilepsy in the differential diagnosis for secondary causes of seizure to ensure appropriate follow-up, as well as improve the quality of life of patients suffering from uncontrolled seizures.