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Nervenheilkunde 2004; 23(04): 200-203
DOI: 10.1055/s-0038-1626365
Original- und Übersichtsarbeiten - Original and Review Articles
Schattauer GmbH

Epilepsie und Hormone

Epilepsy and hormonal changes
G. Luef
1   Universitätsklinik für Neurologie, Innsbruck
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Publication History

Publication Date:
18 January 2018 (online)

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Zusammenfassung

In den letzten Jahren konnte durch zahlreiche Arbeiten bestätigt werden, dass endokrine Störungen bei Frauen und Männern mit Epilepsien vergesellschaftet sind. Die Fertilität epilepsiekranker Frauen ist auf 50-80% im Vergleich zu gesunden gleichaltrigen vermindert. Bei Männern sind vor allem Untersuchungen zu Sexualfunktionsstörungen, z. B. erektiler Dysfunktion (ED), bekannt. Diese treten bei ca. 57% an Epilepsie erkrankter Männer auf, im Gegensatz dazu nur etwa bei 3-9% der Normalbevölkerung. Als Ursachen für hormonelle Störungen werden sowohl die Krankheit Epilepsie selbst als auch Antiepileptika mit deren spezifischen Nebenwirkungsprofilen angesehen. Die Kenntnis um endokrine Störungen als Folge der Epilepsieerkrankung bzw. der antiepileptischen Medikation ermöglicht die erforderliche Beratung und Behandlung betroffener Patienten. Im Folgenden werden mögliche Einflüsse der Epilepsien sowie der Antiepileptika auf das System der Sexualhormone erläutert.

Summary

Reproductive endocrine disorders are commonly associated in women and men with epilepsy. Women with epilepsy are less fertile (50-80%) compared to a healthy population. Men with epilepsy have been found to have an increased risk of erectile dysfunction; up to 57% compared with 3-9% in the general population. These findings have been attributed to epilepsy itself, but antiepileptic drugs also have various effects on endocrine function. Knowledge about reproductive dysfunctions in epileptic patients enables necessary consultations and treatment of concerned patients. Influence of epilepsies and antiepileptic drugs on sexual hormone system will be explained.

Schlüsselwörter

Epilepsie - Hormone - Sexualfunktionsstörungen

Keywords

Epilepsy - hormonal changes - reproductive dysfunctions
 

  • Literatur

  • 1 Martin JB, Reichlin S. Clinical neuroendocrinology. Philadelphia: FA Davis; 1987: 93-128.
    Google Scholar
  • 2 Morrell MJ, Sperling MR, Stecker M. et al. Sexual dysfunction in partial epilepsy: a deficit in physiologic sexual arousal. Neurology 1994; 44: 243-7.
    CrossrefGoogle Scholar
  • 3 Mc Gregor A, Herbert J. Differential effects of excitotoxic basolateral and corticomedial lesions of the amygdala on the behavioural and endocrine responses to either sexual or aggession promoting stimuli in the male rat. Brain Research 1992; 574: 9-20.
    CrossrefGoogle Scholar
  • 4 Bauer J, Stefan H, Schrell U. et al. Serum prolactin concentrations and epilepsy: a study comparing patients in presurgical evaluation with healthy persons and circadian with seizure related variations. Europ Arch of Psych and Clinical Neurosc 1992; 241: 365-71.
    Google Scholar
  • 5 Bauer J. Epilepsy and prolactin in adults: a clinical review. Epilepsy Research 1996; 24: 1-7.
    CrossrefGoogle Scholar
  • 6 Herzog AG, Coleman AE, Jacobs AR. et al. Interictal EEG discharges, reproductive hormones, and menstrual disorders in epilepsy. Ann Neurol 2003; 54: 625-37.
    CrossrefGoogle Scholar
  • 7 Bauer J, Stoffel-Wagner B, Flügel D. et al. Serum androgens return to normal following temporal lobe epilepsy surgery in men. Neurology 2000; 55: 820-4.
    CrossrefGoogle Scholar
  • 8 Duncan S, Blacklaw J, Beastall G. et al. Antiepileptic drug therapy and sexual function in men with epilepsy. Epilepsia 1999; 40: 197-204.
    CrossrefGoogle Scholar
  • 9 Isojärvi JIT, Pakarinen AJ, Ylipalosari PJ. et al. Serum hormones in male epileptic patients receiving anticonvulsant medication. Archives of Neurology 1990; 47: 670-76.
    CrossrefGoogle Scholar
  • 10 Herzog AG, Levesque L, Drislane FW. et al. Phenytoin-induced elevation of serum estradiol and reproductive dysfunction in men with epilepsy. Epilepsia 1991; 32: 550-3.
    CrossrefGoogle Scholar
  • 11 Rättyä J, Turkka J, Pakarinen AJ. et al. Reproductive effects of valpraote, carbamazepine, and oxcarbazepine in men with epilepsy. Neurology 2001; 56: 31-6.
    CrossrefGoogle Scholar
  • 12 Isojärvi JIT, Pakarinen AJ, Myllylä VVA. A prospective study of serum sexhormones during carbamazepine therapy. Epilepsy Research 1991; 09: 139-44.
    CrossrefGoogle Scholar
  • 13 Luef G, Abraham I, Haslinger M. et al. Polycystic ovaries, obesity and insulin resistance in women with epilepsy: a comparative study of carbamazepine and valproic acid in 105 women. J Neurol 2002; 249: 835-41.
    CrossrefGoogle Scholar
  • 14 Luef G, Abraham I, Trinka E. et al. Hyperandrogenism, postprandial hyperinsulism and the risk of PCOS in a cross sectional study of women with epilepsy treated with valproate. Epilepsy Res 2002; 48: 91-102.
    CrossrefPubMedGoogle Scholar
  • 15 Luef G, Abraham I, Hoppichler F. et al. Increase in postprandial serum insulin levels in epileptic patients with valproic acid therapy. Metabolism 2002; 10: 1274-78.
    Google Scholar
  • 16 Blumer D. The psychiatric dimension of epilepsy: historical perspective and current significance. In: Psychiatric aspects of epilepsy. Washington: American Psychiatric press; 1985: 1-65.
    Google Scholar
  • 17 Gastaut H, Collomb H. Etude du comportement sexual chez les épileptiques psychomotors. Annales Medico-Psychologiques 1954; 112: 657-96.
    Google Scholar
  • 18 Herzog AG, Drislane FW, Schomer DL. Abnormal pulsatile secretion of luteinizing hormone in men with epilepsy: relationship to laterality and nature of paroxysmal discharges. Neurology 1990; 40: 1557-61.
    CrossrefGoogle Scholar
  • 19 Herzog AG. Reproductive endocrine considerations and hormonal therapy for men with epilepsy. Epilepsia 1991; 32: 34-7.
    CrossrefGoogle Scholar
  • 20 Roste LS, Tauboll E, Haugen TB. et al. Alterations in semen parameters in men with epilepsy treated with valproate or carbamazepine monotherapy. Eur J Neurol 2003; 10: 501-6.
    CrossrefGoogle Scholar
  • 21 Isojarvi JI, Lofgren E, Juntunen KS. et al. Effect of epilepsy and antiepileptic drugs on male reproductive health. Neurology 2004; 62: 247-53.
    CrossrefGoogle Scholar