Laterality and location influence catamenial seizure expression in women with partial epilepsy

• DOI: 10.1212/wnl.0b013e3181ae7adf
• Publication Date: 2009-07-20T20:39:25Z
• Authors: M. Quigg; S. D. Smithson; K. M. Fowler; T. Sursal; A. G. Herzog
• Keywords: Repeated measures design

Objective: The temporal distribution of seizures in women with localization-related epilepsy occurs periodically according to a model “clock” the peak phase occurrence corresponding menstrual onset. location and laterality epileptic lesion as well patient age may affect periodicity.Methods: Baseline data from seizure diaries ∼3 months duration were obtained 100 enrolled trial hormonal therapy for epilepsy. Durations individual cycles normalized common period. Normalized then combined create distributions evaluated by localization (lobar: [TL], extratemporal [XL], multifocal [MF], unknown), lateralization (left, right, bilateral, age. Distributions analysis variance (ANOVA) curve-fitted nonlinear least squares cosinor analysis.Results: A total 71 patients had TL (left = 25, right 29, bilateral 17), 10 XL, 14 MF, 5 unknown foci. XL MF occurred randomly across 28-day cycle. 875, 706) nonrandomly (ANOVA p 0.0003) cyclically near onset menses ([value ± SD] 1.6 2.3 days, period 27.0 days). Left-side peaked at 0.04, 0.0 3.0 30 days); right-side randomly. Age did not have cyclical effect. Women below median significantly higher rate than those above age.Conclusion: Circalunar rhythms women, therefore, possibly strategies treatments catamenial epilepsy, vary neuroanatomic substrate focus.