Treatment for Catamenial Epilepsy
A combination of different therapies is how catamenial epilepsy is treated. These include:
Anti-epilepsy drugs
The first treatment recommended is anti-epilepsy drugs (AEDs) [4]. Although this may not cure your condition, the seizures may continue due to the hormonal fluctuations during the menstrual cycle. However, the seizures usually continue. Some AEDs can alter levels of reproductive hormones, which will only worsen your seizures.
Your doctor may prescribe higher doses when you are most likely to have worse seizures. You might also have to take multiple AEDs.
Hormonal drugs
Hormonal drugs are prescribed together with AEDs. Hormonal drugs are to increase progesterone and reduce estrogen. Examples of these drugs are:
- Natural progesterone
- Oral contraceptive
- Clomiphene
- Gonadotropin-releasing hormone (GnRH) analogs [5]
The medicine prescribed will depend on if your periods are regular or irregular. There might be an interaction between hormonal drugs and AEDs. A neurologist can help determine what hormonal drug is safest for your condition.
Change in diet
You will need to remove certain foods that may trigger seizures from your diet. A seizure diet may also be recommended, or a low-carbohydrate diet, like the modified Atkins diet.
Surgery
Surgery may be recommended in severe cases. Surgery will remove the ovaries, thereby completely stopping menstruation and providing relief. Epilepsy surgery can also be done on people with catamenial epilepsy, targeting the side of the brain where the seizures originate.