Menstrual cycle seizures

A low dosage of progestin ( mini-pill ) is used, in the form of medroxyprogesterone acetate, which is active at a very low dose. The mini-pill does not inhibit ovulation, but rather interferes with the endometrium and the cervical mucus. The use of this pill prevents most of the side effects of oral contraception, specifically nausea, water retention, and in some cases thrombophlebitis. However, a lower success rate and other frequent side effects have reduced the widespread acceptance of this preparation. Nevertheless, the mini-pill has a role to play in certain specific situations. For example, in an uncommon form of epilepsy called catamenial epilepsy, female patients will experience seizures at particular times during their menstrual cycle, reflecting the fact that seizure focus is stimulated by estrogens but inhibited by progestins. In such women, the mini-pill may afford not only birth control but also improved seizure control. 

A 13-year-old girl, who had previously had surgery and radiotherapy for a medulloblastoma, developed atypical absence seizures for the first time after 3 months of therapy with leuprorelin. The seizures stopped 1 month after treatment was withdrawn and did not recur until 30 months later. The seizures were not related to estradiol concentrations or the menstrual cycle. 

Roscizeweska D, Buniner B, Guz I, Sawisza H. 1986. Ovarian hormones anticonvulsant group and seizures during the menstrual cycle in women with epilepsy. J. Neurol. Neurosurg. Psychiatr. 49 47-51. 

---