[Epilepsy and hormones].

Abstract

The paper contains a review of reports concerned with how for hormones, epileptic seizures and antiepileptic drugs can be influenced by one another. Hormones influence brain excitability but, on the other hand, both epileptic seizures and antiepileptic drugs may alter hormone secretion and metabolism. Effect of hormones on seizures--Experimental studies revealed the properties which inhibit or stimulate convulsive reactivity of different hormones. Progesterone, testosterone, adrenocorticotropin and desoxycorticosterone are responsible for an increase in seizure threshold, while estradiol, cortisol and thyroid hormones cause a reduction. Effect of seizures on hormones--Epileptic seizures, chiefly tonic-clonic, also complex partial and sometimes simple partial seizures, result in "the hormonal storm". Immediately after an epileptic seizure, an increase is found in serum concentrations of prolactin, cortisol, adrenocorticotropin, triidothyronine, thyroxin, thyrotropin, luteotropin, follicular stimulating hormone and growth hormone. These changes may persist for two hours, while prolactin concentration even for 24 hours after a seizure. Effect of antiepileptic drugs on hormones--Antiepileptic drugs may affect hypothalamus-pituitary function directly or indirectly through neurotransmitter system. By induction of hepatic microsomal enzymes, some antiepileptic drugs cause acceleration of hormone metabolism, reducing hormone serum concentrations. Moreover, antiepileptic drugs enhance sex hormone binding globulin SHBG/synthesis, increase binding of these hormones and reduce their active fraction concentration in serum. Recognition of the relationship between epilepsy and hormonal system is necessary to obtain better understanding of this disease.