Dear Doctor;

I suffer from fits, which mainly occur during periods. I have improper menses and growth of the body is also not proper according to my age. Every time after fits, my buccal cavity is injured, there is bleeding and sometimes even the tongue gets injured. I usually stop in between while talking and then forget what I was talking about. How can fits be managed? Olga, 23. 

Dear Olga, 

Many women with epilepsy have exacerbation of seizures around menstrual cycles, a condition known as catamenial epilepsy. This occurs due to their bodies being unusually sensitive to endogenous hormonal changes.

The seizures are said to occur due to excitatory effects of estrogens on the brain cells. If mostly occurring around second half of cycles, the cycles are an ovulatory, that is, eggs are not produced. Sometimes seizures start in the temporal lobe a part of brain that is close to centers regulating hormone production.

In such cases production of other hormones is also affected thus affecting secondary sexual characteristics as per the age. A CT scan done of the head can help to know if there is a tumor or parasitic cysts like neurocysticercosis causing the seizures and other physical changes. If present, that can be treated by surgery. If you keep a record of exact days of seizures and frequency, it shall help in treatment. Any anticonvulsant medicine like sodium valproate or phenobarbitol taken in optimum doses  shall help to prevent seizures. A gag put in mouth just as the seizure commences  can prevent tongue bite.

Around the days of menstrual cycles when seizures are likely to occur avoid being in crowded noisy places. Avoid watching television or movies. Any kind of excitation of brain cells can precipitate seizures.