the two objectives of this study are:1)to measure and compare the lipid metabolomics during the menstrual, peri- ovulatory and luteal phases in women with catamenial epilepsy, women with epilepsy but without catamenial seizures and women without epilepsy and 2)to measure and compare the lipid metabolomics in women with catamenial epilepsy under treatment with hormonal therapy and correlate the levels with the treatment outcome (responders vs non responders).

Epilepsy is one of the most common devastating neurological conditions worldwide. It is estimated that one third of the population with epilepsy does not respond to medications and will continue to have seizures regardless appropriate pharmacological treatment. It is not well understood what drives breakthrough seizures in most of this patients. Some evidence shows that in some patients, breakthrough seizures follows a cyclic pattern. A common example is catamenial epilepsy, but cyclic breakthrough seizures also occur in men. An interesting idea is that cyclic variation of certain metabolites in the body may drive the cyclic pattern of breakthroughs. If we can predict this variation, we may be able to predict and prevent seizures. Measuring metabolomics in blood or in urine may be a plausible tool to detect this variation.

women with catamenial epilepsy will be recruited from the UF Epilepsy clinic. We will measure lipid metabolomics, estrogen and progesterone levels during different phases of the menstrual cycle. We will have two control groups of 5 patients each:  1) women with epilepsy and non-catamenial seizures and 2) healthy pre menopausal women without epilepsy. We will compare the lipid metabolomics between the three groups and between the different phases of the cycle. We will also measure lipid metabolomics on patients on hormonal therapy with progesterone and compare the levels between responders and non responders.

this study is currently enrolling patients.

In catamenial epilepsy, breakthroughs follow a cyclic and potentially predictable pattern: the identification of metabolites that are specifically elevated in woman with catamenial epilepsy will allow the development of further studies evaluating the response to treatment for this condition and may be used as predictors of favorable or unfavorable outcomes.