Altered pulsatile secretion of luteinizing hormone in women with epilepsy

Abstract

Menstrual disorders and infertility are common among women with epilepsy of temporal lobe origin (TLE). Reproductive endocrine disorders may be the cause. Polycystic ovarian syndrome (PCO) and hypothalamic amenorrhea (hypogonadotropic hypogonadism, HH), in particular, are significantly overrepresented and attributable to hypothalamic dysfunction. We therefore compared the hypothalamic function of 14 women with clinically and electrographically documented TLE with that of eight age-matched normal controls by determining the interictal pulse frequency and amplitude of luteinizing hormone (LH) secretion. Serum for LH measurement was drawn every 15 minutes from 8 AM to 4 PM in both groups. LH pulse frequency values were significantly more variable (p < 0.05) and lower (p < 0.05) among women with TLE than among controls. Women with left temporal EEG foci showed a trend toward higher pulse frequencies compared to women with right foci (p = 0.05 to 0.10). Among five women with reproductive endocrine disorders, the three with PCO had left-sided foci and average LH pulse frequency two times higher than that of the two women with HH, who had right-sided foci. Eight reproductively normal, medically treated women with TLE had significantly lower LH pulse frequencies than did the one reproductively normal, untreated woman with TLE (p < 0.05) and the eight normal controls (p < 0.001). These findings suggest that LH pulse frequencies in women with TLE may be influenced by the laterality of the epileptic focus, the reproductive endocrine status, and the use of antiseizure medications.

Serum Sex Hormones Are Altered in Patients with Chronic Temporal Lobe Epilepsy Receiving Anticonvulsant Medication

“…This indicates an altered hypothalamic function (24). In these patients, various AEDs did not influence the finding.…”

Alterações sexuais na epilepsia: resultados de uma avaliação multidisciplinar

“…Singer 2 assinalou que as endocrinopatias contribuem para impotência orgânica em 5 a 35 % dos casos. As descargas epileptiformes, especialmente as de estruturas límbicas, modulam a resposta hipotalâmica e alteram a secreção hormonal 20 . Podem ser verificadas alterações do eixo hipotálamo-hipófise-gonadal, como hiperprolactinemia e hipogonadismo hipo ou hipergonadotrófico 19 .…”

Hormon- und Sexualstörungen bei Epilepsie

“…Möglicherweise variiert bei einer Temporallappenepilepsie (TLE) das resultierende, gestörte LH-Pulsatilitäts-muster abhängig von der Lateralität des epileptogenen Fokus [3,21]. Ein rechtsseitiger Fokus führt häufiger zu einer LHSuppression und einem hypogonadotropen Hypogonadismus (hypothalamische Ovarialinsuffizienz).…”