Seizure duration may increase thyroid-stimulating hormone levels in children experiencing a seizure

Abstract

Objective Variations in hormone levels are a direct effect of epileptic discharges in both animals and humans, and seizure can affect the hypothalamus–pituitary–thyroid axis. The purpose of this study was to determine which parameters could affect the alternation of thyroid hormones in children experiencing seizure. Methods We retrospectively reviewed the medical records of 181 pediatric patients with seizure and compared three thyroid hormones (serum thyroid-stimulating hormone [TSH], free thyroxine [fT4], and triiodothyronine [T3]) between initial (admission to hospital) and follow-up (2 weeks later) testing. Results Multivariable logistic regression models were used to determine which six parameters (gender, age, seizure accompanying with fever, seizure type, seizure duration, and anti-epileptic drug medication) could help to explain the higher initial TSH levels in pediatric seizure. Only seizure duration in patients with an increase in TSH levels was significantly longer compared with patients with normal TSH at the time of initial testing. Conclusion Neuronal excitability by seizure can cause thyroid hormonal changes, which likely reflects changes in hypothalamic function.

Risk Factors for Clinically Overt Hypothyroidism in Unselected Population of Adult Epilepsy Patients

“…Higher seizure frequency may interfere with the hypothalamic axis and alter the TSH levels. [14][15][16] Another finding of our study was that the duration of epilepsy was longer in epilepsy patients with hypothyroidism. However, according to the logistic regression analysis, this was not an independent risk factor for hypothyroidism.…”

Hormonal Changes in Women with Epilepsy

“…Another animal study demonstrated that the elevation of pituitary hormone levels subsequent to seizure events may be attributed to monoamine mechanisms. 19 Clinically, the elevation of prolactin, follicle-stimulating hormone, growth hormone, and cortisol levels was observed after seizures compared to controls, 20 while Han et al 21 reported that serum TSH levels were significantly increased following a seizure, probably suggesting epileptic seizures can interfere the function of the HPT axis. In addition to the immediate impacts of seizures on hormonal changes, various factors such as seizure type, duration, epileptiform discharge on EEG, and comorbidity have also been associated with alterations in THs.…”