Interictal EEG discharges, reproductive hormones, and menstrual disorders in epilepsy.
We evaluated reproductive endocrine function in women with unilateral temporolimbic epilepsy and normal control subjects to assess the effects of epilepsy, epilepsy laterality, and antiepileptic drug use on the cerebral regulation of hormonal secretion. The findings indicate that reproductive endocrine function differs between women with epilepsy and normal control subjects. Significant differences exist at all levels of the reproductive neuroendocrine axis, that is, hypothalamus, pituitary, and peripheral gland. Differences show significant relationships to the epilepsy itself as well as to medication use. Reproductive neuroendocrine changes occur in a stochastic manner such that the laterality of unilateral temporolimbic discharges is associated with predictable directional changes in hormonal secretion at all levels of the reproductive neuroendocrine axis. These directional changes are consistent with the finding that different reproductive disorders may develop in relation to left- and right-sided temporolimbic epilepsy. Hormonal changes can show close temporal relationship to the occurrence of interictal epileptiform discharges and may vary in relation to the laterality of the discharges. Antiepileptic drugs differ in their effects on reproductive hormone levels. There are notable differences between enzyme-inducing and noninducing drugs. Menstrual disorders are more common among women with interictal discharges as well as women with abnormal hormonal findings.
Harvard Neuroendocrine Unit, Beth Israel Deaconess Medical Center, 330 Brooklione Avenue, Boston, MA 02215, USA. aherzog@caregroup.harvard.edu
Andrew G
AG
Herzog
Anton E
AE
Coleman
Alan R
AR
Jacobs
Pavel
P
Klein
Mark N
MN
Friedman
Frank W
FW
Drislane
Bernard J
BJ
Ransil
Donald L
DL
Schomer
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality; D006065:Gonadotropins, Pituitary / Q000097:blood*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008599:Menstruation Disturbances / Q000150:complications / Q000503:physiopathology*
D000927:Anticonvulsants; D006065:Gonadotropins, Pituitary