Drug-Resistant Epilepsy May Cause Seizures During Menstrual Cycle

In generalized epilepsy, seizures occur on both sides of the brain, while focal epilepsy seizures begin in only one part of the brain.

For the first time, frequent seizures during the menstrual cycle in women with genetic generalized epilepsy have been linked to drug-resistant epilepsy, which are taken by women when anti-seizure medications don’t work.

Women who have genetic generalized epilepsy called catamenial epilepsy- where seizure frequency increases during their menstrual cycle, are more likely to have drug-resistant epilepsy compared to women who experience no changes in frequency. This study will help in leading to tailored treatments.

“Typically, genetic generalized epilepsy is thought to respond better to anti-seizure medications than focal epilepsy. However, previous studies suggest a minority of individuals, between 18 percent and 36 percent, with genetic generalized epilepsy, do not respond well to these medications,” said senior author Gary A. Heiman, an associate professor in the Department of Genetics in the School of Arts and Sciences at Rutgers University-New Brunswick.

The research cannot tell as to why seizures in these individuals do not respond well, and further research should be concluded to investigate why. Researchers were surprised by the association between women’s menstrual cycle and those with drug-resistant genetic generalized epilepsy. If further research was held to understand the reasons for this association, it might lead to alternative, personalized treatment options for at least some patients.

In generalized epilepsy, seizures occur on both sides of the brain, while focal epilepsy seizures begin in only one part of the brain. Anti-seizure drugs restrict the spread of seizures in the brain and function for about two-thirds of people with epilepsy. Surgery is the other options to treat epilepsy.

The study aim was to develop and validate a model for predicting generalized epilepsy that resists drug treatment. Such models will enable healthcare professionals to identify patients who may benefit from more aggressive or different kinds of treatment.

There is a link between women whose seizures increase during their menstrual cycle and have drug-resistant genetic generalized epilepsy and these women represent a homogeneous group with a specific cause.

“Genetic and treatment studies of these women could uncover the reason, and tailored treatment could be developed, Heiman said. Although our study sample is one of the largest to date and found in two independent samples, further investigation using larger sample sizes is required.”


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