Pharmacotherapy of catamenial epilepsy

Epilepsy is a neurological condition characterized by repeated seizures, which are clinical manifestations of abnormal electrical discharges in the brain. Epilepsy is the second most common neurological disorder in India. Epilepsy affects an estimated 7 million people in India, and 50 million worldwide. Approximately 40% of them are women. The prevalence of epilepsy is 0.7% in India, which is comparable to the United States and other developed nations. The estimated incidence rate ranges from 40 to 60 per 100,000 population per year. The WHO estimated that approximately 80% people with epilepsy live in developing countries and most of them do not get adequate medical treatment. Among the two distinct epileptic seizures (partial and generalized), the bulk of cases in India belong to generalized seizures. Antiepileptic drugs (AEDs) are the mainstay for the treatment of epilepsy, and generally suppress seizure occurrence. [Table 1] None of these agents, however, meet the characteristics of an ideal AED, that is, protecting against seizures without inducing adverse effects that impair the patient’s quality of life. Despite many advances in epilepsy research, the pharmacotherapy of epilepsy remains largely empirical owing to the lack of understanding of the underlying pathology. Moreover, approximately 30% of people with epilepsy have “intractable seizures” that do not respond to even the best available treatment. Epilepsy is characterized by the unpredictable occurrence Pharmacotherapy of catamenial epilepsy