In this chapter, the hormonal influences on epilepsy are discussed. Catamenial epilepsy is defined when seizure frequency increases correlated with certain phases of the menstrual cycle. The most common type as demonstrated by this patient is the perimenstrual exacerbation, C1. This corresponds to a progesterone decline. The next most common pattern is the periovulatory exacerbation, C2. This is characterized by an increase in seizure frequency associated with ovulation and the associated surge in estrogen. The luteal pattern, C3, is the least frequent. In this pattern, seizure frequency increases in the luteal phase of the menstrual cycle. An approach to treatment of catamenial epilepsy is reviewed.
