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The notion that a relationship exists between epileptic seizures in a woman and her menstrual cycle is as old as Hippocrates and as recent as Lennox. The authors review briefly the literature that supports this connection, then carefully proceed to refute it by a multidisciplinary study of thirty epileptic women. They
utilized the Shorr technique of daily vaginal smears and basal temperatures to divide the menstrual cycles of the women into five phases: ovulation, progestation, premenstruation, menstruation, and proliferation. They carried out weekly psychiatric interviews, repeated psychological tests, frequent electroencephalograms, and hydration determinations, against which data they noted the frequency and time of occurrence of seizures in each woman over a three-year period. Fifty-seven per cent of the women themselves believed that there was a relation between their seizures and menstruation, but the study revealed that there was no such phase-preference. Instead, seizures occurred at random through the whole menstrual cycle. Some of the women showed an individual tendency to seizures in a particular phase of their cycle, but this heightened incidence was not more frequently related to the menstrual phase than to any of the other four phases. This heightened predisposition to seizures at a particular phase seemed to be determined most strongly by psychological factors centering around the conscious and unconscious meaning of the phase to the particular woman, and the data indicated that changes in phase-preference can occur with shifts in the emotional conflicts of the subject.