Epilepsy is a neurological brain disorder. It causes temporary episodes of disturbed neuronal activity in the brain. When neurons fire abnormally, people can experience strange sensations, emotions and behaviour. Muscle spasms, convulsions and a loss of consciousness can occur. Having one seizure is not regarded as epilepsy.

Reports show that infants and the elderly experience them more frequently. Approximately 50 million around the world experience them, modern day living increases the chance of having them. In many cases, epilepsy is a lifelong problem.

Some causes are:

  • stroke
  • dementia
  • traumatic brain injury (TBI)
  • congenital brain defect
  • brain injury that occurs during a new birth
  • phenylketoonuria
  • brain tumour
  • abnormal blood vessels in the brain
  • other illness that can damage or destroy brain tissue
  • reproductive hormones

An EEG is done to check electrical activity in the brain. An MRI or CT scan is often done to check which part of the brain is affected. Although medication can help to control seizures in most, 30% are not helped.

The menstrual cycle can either excite neuronal activity, or calm it. Reproductive hormones are neuroactive, and vary during the menstrual cycle.

There appear to be 3, possibly more, patterns of catamenial seizure exacerbation:

  • pre-menstrual days
  • pre-ovulatory days
  • during the entire luteal phase in anovulatory cycles

Approximately 1/3 of women with seizures have catamenial epilepsy.

Trials have found that seizures which are hormone sensitive respond well to hormone treatment. Progesterone has proved to
be a successful treatment for women, testosterone and estrogen antagonists in men. Men are given aromatase inhibitors which prevents the conversion of testosterone to estrogen.

The 3 estrogens are:

  • estrone (E1)
  • estradiol (E2)
  • estriol (E3)

cause neuronal excitability. Estradiol being the main activator during the reproductive years, while the higher estrone levels in menopause are also implicated. Estriol increases in pregnancy and inhibits GABA which is one of the most calming neurotransmitters.

Studies have found that seizures increase after women give birth. Progesterone levels drop sharply after giving birth so it is not surprising that these attacks take place after giving birth especially if she has never experienced an attack before.

Progesterone has neuroprotective effects in the brain, in particular its metabolite allopregnanolone. Increased seizures are more noticeable during the few days before menstruation, when the ratio of progesterone to estrogen is low to very low and during the estrogen surge in the mid to late follicular phase when progesterone levels are very low.

Only after about 50 hours prior to ovulation, when there is a surge of progesterone from the brain or ovulation itself has occurred, progesterone levels start to rise.

Anovulation or a defective luteal phase results in low progesterone levels. A defective luteal phase can be one that is too short, or the corpus luteum is not producing sufficient progesterone. This would not make estrogen the dominant hormone, progesterone should be dominant in the luteal phase.

This is particularly noticeable during Peri-Menopause when anovulatory cycles increase until the onset of Menopause. This is when the ovaries stop producing viable eggs. Interesting to note is that there is an increase in seizures during peri-menopause and a noticeable drop in menopause. HRT increases these attacks in women with catamenial epilepsy. Again it all points to hormones.

Studies and a trial were done in 1974 using supplemental vitamin D3 as an epilepsy treatment. The number of attacks were reduced during treatment, but not with the placebo. Now 40 years later, both clinical and experimental studies still show a link between vitamin D3 dysfunction and epilepsy.

There are many anti-epileptic drugs that actually reduce vitamin D3 levels to shockingly low levels. Many also reduce calcium levels, resulting in osteomalacia (softening of the bones).

Vitamin D3 is vital for normal cell function and is essential not only for brain development in utero, but in the adult brain too. Like progesterone, vitamin D3 is neuroprotective. Women with low levels of vitamin D3 while pregnant are more likely to have infants with epilepsy.

Evidence clearly points to an increase in seizures where one is deficient in vitamin D3. Dull overcast days are also associated with an increase in seizure attacks. Little sunshine means little vitamin D3 is produced in the body. Some seizures are less likely to occur on bright sunny days.

Coeliac disease can increase the risk of epilepsy. This is a greatly underdiagnosed condition and suggests that its treatment would provide an indirect epilepsy treatment.

Infertility causes a greater risk for epilepsy in women. Premature ovarian failure and menopause at a younger age also contributes to these attacks.

Whilst there are no studies to back this up, it seems likely that a lack of progesterone and vitamin D3 are possible causes. Both are vital for normal ovarian function, both regulate gene expression and have a positive fundamental effect on cell differentiation and growth. Both stimulate neurotrophic factors in the nervous system.

Studies on Traumatic Brain Injury (TBI) show that a lack of vitamin D3 reduces the benefits of progesterone. In over 30 years of testing, progesterone is the only substance which has shown dramatic results in TBI. When adding vitamin D3 to the protocol, further benefits were achieved.

Infants born to mothers who have a vitamin D deficiency are at great risk of seizures after birth. This also applies if a mother is deficient in taurine. Further checks should be made for unstable blood glucose and allergenic foods, avoid triggering agents such as alcohol, aspartame and MSG wherever possible.

Natural Epilepsy Treatment

For catamenial epilepsy, progesterone therapy should be considered and no less than 200mg per day or more, dependent on symptoms, is needed. The late Dr Kittie Dalton, M.D., found the minimum dose via suppositories was 400mg twice daily.

For men with high estrogen levels, progesterone therapy should also be considered, using between 10-100mg per day, more if symptoms are severe.

As a vitamin D3 deficiency is found in epileptics, especially those on anti-convulsants, a test is essential. The following websites will help you.

The blood level should be between 70-100ng.ml or 175-250nmol/L and NOT the 30ng/ml or 75nmol/L the labs and doctors use as a cut off point for adequate levels. Incorrect! The minimum daily dose of vitamin D3 should be 5 000iu's per day, more if levels are very low. Latest research indicates that it should actually be 10 000iu's per day, see here.

Several nutrients should be considered as they reduce seizure exacerbation:

  • vitamin B6
  • magnesium - a co-factor for vitamin D3 and therefore vital
  • taurine
  • glycine
  • dimethylglycine
  • vitamin E
  • selenium
  • riboflavin
  • zinc
  • melatonin

Some anti-convulsants reduce:

  • folic acid
  • vitamin B6
  • biotin
  • carnitine
  • vitamin D3 in particular

more needs to be taken if taking a anti-convulsants.

Conventional Epilepsy Treatment

  • Drugs - control the electrical activity. Many epilepsy drugs can cause birth defects if the moth is taking them
    while pregnant.
  • Surgery - removes the cause if it is a tumour etc
  • Diet - the Ketogenic Diet can be helpful in some cases, particularly children. This involves a low carb, high fat
    diet. See Vanderbilt University

Website References for Epilepsy Treatment

Epilepsy Reference Papers

Phase III Progesterone Therapy Trial For Women With Epilepsy Has Favorable Outcome

Female reproductive steroids and neuronal excitability

Hormonal Therapy for Epilepsy

Epilepsy and Menopause

Managing Epilepsy in Pregnancy

No effects of the gonadal hormones on photoparoxysmal EEG responses in idiopathic generalised epilepsy

Light therapy as a treatment for Epilepsy

Reading epilepsy as the initial symptom of idiopathic hypoparathyroidism

Infertility Risk Higher for Women with Epilepsy

Effect of carbamazepine therapy on vitamin D and parathormone in epileptic children

Neurosteroid withdrawal regulates GABA-A receptor α4-subunit expression and seizure susceptibility by activation of progesterone receptor-independent early growth response factor-3 pathway

Catamenial epilepsy: hormonal aspects

Benefits of sunlight: vitamin D deficiency might increase the risk of sudden unexpected death in Epilepsy

Vitamin D, a neuro-immunomodulator: implications for neurodegenerative and autoimmune diseases

Hormone Replacement Therapy: Will it affect seizure control and AED levels?

Issues for mature women with Epilepsy

Reproductive hormonal changes and catamenial pattern in adolescent females with Epilepsy

Does menopause affect the Epilepsy?

Vitamin D status in children with intractable epilepsy, and impact of the ketogenic diet

New clues about vitamin D functions in the nervous system