title: Seizure frequency and sex steroids in women with partial epilepsy on antiepileptic therapy.
abstract: OBJECTIVE
  Neuroactive sex steroids influence neuron excitability, which is enhanced by estradiol (E2) and decreased by progesterone (Pg). In epilepsy, the production, metabolism, biologic availability, and activity of sex hormones may be affected by seizures themselves or by antiepileptic drugs (AEDs). This cross-sectional observational study was aimed at evaluating the relationships between sex steroids, seizure frequency, and other clinical parameters in women with partial epilepsy (PE) on AED treatments.
  
  
  METHODS
  Serum E2, Pg, sex hormone binding globulin (SHBG) levels, free E2 (fE2), and E2/Pg ratios were determined during the follicular and luteal phases in 72 adult women with PE, and in 30 healthy controls. Hormonal data were correlated with seizure frequency, age, body weight, body mass index (BMI), disease onset and duration, and AED therapies.
  
  
  RESULTS
  In patients, E2, fE2, and Pg levels were lower in both ovarian phases, whereas those of SHBG were higher than in controls. No significant changes in hormone levels and in prevalence of anovulatory cycles were observed between patients grouped according to their seizure frequency. However, when compared with those in healthy controls, luteal fE2 and Pg levels were chiefly impaired in women with more frequent seizures, mostly undergoing AED polytherapies, but not in those with absent or rarer seizures.
  
  
  CONCLUSIONS
  The actual changes in sex steroid levels and E2/Pg ratios did not explain an increased seizure frequency in adult women with AED-treated PE, but patients with more severe disease showed more relevant changes in their sex hormone profile and impaired Pg levels during the luteal phase.
authors: Department of Endocrine and Medical Sciences, University of Genova, Italy. gmurialdo@unige.it
authors: Giovanni
authors: G
authors: Murialdo
authors: Flavia
authors: F
authors: Magri
authors: Gianluca
authors: G
authors: Tamagno
authors: Pietro
authors: P
authors: Ameri
authors: Antonella
authors: A
authors: Camera
authors: Silvia
authors: S
authors: Colnaghi
authors: Piero
authors: P
authors: Perucca
authors: Giambattista
authors: G
authors: Ravera
authors: Carlo Andrea
authors: CA
authors: Galimberti
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000627:therapeutic use*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004828:Epilepsies, Partial / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D011374:Progesterone / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013223:Statistics as Topic; D013256:Steroids / Q000097:blood*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D012738:Sex Hormone-Binding Globulin; D013256:Steroids; D011374:Progesterone; D004958:Estradiol