Hormonal Effects on Epilepsy in Women

Klein, Pave; Herzog, Andrew G.

doi:10.1111/j.1528-1157.1998.tb02602.x

Cited by 54 publications

(29 citation statements)

References 82 publications

(76 reference statements)

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“…Clinically, estrogen reportedly increases cortical excitability in humans during transcranial magnetic stimulation (41), and high doses increase the incidence of aura during hormone replacement therapy (42)(43)(44). Moreover, higher levels of estrogen are associated with an increase in seizure frequency in females (45). Experimentally, seizure thresholds are decreased during peak estrogen levels (46), and amygdala kindling is increased (47).…”

Section: Discussionmentioning

confidence: 99%

Genetic and hormonal factors modulate spreading depression and transient hemiparesis in mouse models of familial hemiplegic migraine type 1

Eikermann-Haerter¹,

Dileköz²,

Kudo³

et al. 2008

J. Clin. Invest.

189

290

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Familial hemiplegic migraine type 1 (FHM1) is an autosomal dominant subtype of migraine with aura that is associated with hemiparesis. As with other types of migraine, it affects women more frequently than men. FHM1 is caused by mutations in the CACNA1A gene, which encodes the α 1A subunit of Ca v 2.1 channels; the R192Q mutation in CACNA1A causes a mild form of FHM1, whereas the S218L mutation causes a severe, often lethal phenotype. Spreading depression (SD), a slowly propagating neuronal and glial cell depolarization that leads to depression of neuronal activity, is the most likely cause of migraine aura. Here, we have shown that transgenic mice expressing R192Q or S218L FHM1 mutations have increased SD frequency and propagation speed; enhanced corticostriatal propagation; and, similar to the human FHM1 phenotype, more severe and prolonged post-SD neurological deficits. The susceptibility to SD and neurological deficits is affected by allele dosage and is higher in S218L than R192Q mutants. Further, female S218L and R192Q mutant mice were more susceptible to SD and neurological deficits than males. This sex difference was abrogated by ovariectomy and senescence and was partially restored by estrogen replacement, implicating ovarian hormones in the observed sex differences in humans with FHM1. These findings demonstrate that genetic and hormonal factors modulate susceptibility to SD and neurological deficits in FHM1 mutant mice, providing a potential mechanism for the phenotypic diversity of human migraine and aura.

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Section: Discussionmentioning

confidence: 99%

Genetic and hormonal factors modulate spreading depression and transient hemiparesis in mouse models of familial hemiplegic migraine type 1

Eikermann-Haerter¹,

Dileköz²,

Kudo³

et al. 2008

J. Clin. Invest.

189

290

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show abstract

“…205 This phenomenon may be due to the neuroactive properties of steroid hormones and the cyclic variations in their serum levels. 206 Oestrogen lowers seizure thresholds in most adult animal studies. 207 This effect on neuronal excitability is mediated by cytosolic neuronal oestrogen receptors, which are very plentiful in the medial and cortical amygdaloid nuclei and less abundant in the hippocampal pyramidal cell layer and subiculum.…”

Section: Menstrual Cycle and Pregnancymentioning

confidence: 99%

Cortical hyperexcitability and epileptogenesis: Understanding the mechanisms of epilepsy - Part 2

Badawy¹,

Harvey²,

Macdonell³

2009

Journal of Clinical Neuroscience

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“…The complexity of the symptomatology probably results from multiple mediating factors. That a release from inhibitory influences is the hallmark of the late luteal phase is suggested by the increase in seizure susceptibility reported at this time in individuals with preexisting epileptic foci (i. e., 'catamenial epilepsy') [16,17], a phenomenon also observed during the mid-cycle peak in E 2 . Increases in seizure activity do not occur during the hormone withdrawal phase, but at a time when progesterone levels are at their nadir, suggesting a higher threshold for seizure induction compared with reports of adverse mood.…”

Section: Introductionmentioning

confidence: 82%

Pre-menstrual steroids

Smith

2001

CMLS, Cell. Mol. Life Sci.

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A number of steroid hormones and their metabolites fluctuate in the circulation across the human menstrual cycle. In addition to their classic actions on the hypothalamo-pituitary-gonadal axis, many of these hormones act as 'neuroactive steroids' to alter the function of neurotransmitters, such as GABA, within central nervous system circuits. Clinically, these steroids are important because they have not only acute but also long-term effects, and 'withdrawal' properties. This review discusses the effects of steroids such as 3alpha-OH-5alpha-pregnan-20-one (3alpha,5alpha-THP or allopregnanolone) which alter GABA function in distinct ways dependent upon the time course of exposure, to either enhance or decrease inhibition in the brain. These effects are discussed in light of recent clinical findings which seek to further characterize the steroid milieu which underlies pre-menstrual dysphoria.

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Hormonal Effects on Epilepsy in Women

Cited by 54 publications

References 82 publications

Genetic and hormonal factors modulate spreading depression and transient hemiparesis in mouse models of familial hemiplegic migraine type 1

Genetic and hormonal factors modulate spreading depression and transient hemiparesis in mouse models of familial hemiplegic migraine type 1

Cortical hyperexcitability and epileptogenesis: Understanding the mechanisms of epilepsy - Part 2

Pre-menstrual steroids

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