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Results for “TLE”

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At least 397 records · Page 22Linked to original sources

PubMed1999

Carbamazepine effects on Na+ currents in human dentate granule cells from epileptogenic tissue.

PURPOSE: Carbamazepine (CBZ) is a well-established drug in the therapy of temporal lobe epilepsy (TLE). The anticonvulsant action of CBZ has been explained mainly by use-dependent effects on voltage-dependent Na+ channels in various nonhuman cell type. However, it is unclear whether Na+ currents in neurons within the focal epileptogenic area of patients with medically intractable TLE show similar characteristics. METHODS: Therefore we used the whole-cell patch-clamp technique to investigate the effects of CBZ on voltage-dependent Na+ currents in 23 acutely isolated dentate granule cells (DGCs) from the resected hippocampus of eight patients with medically intractable TLE. RESULTS: As in findings in animal preparations, CBZ significantly reduced the amplitude of the Na+ current and significantly shifted the current-voltage dependence of the steady-state inactivation in the hyperpolarizing direction. In contrast, the rapid component of the recovery from inactivation of the Na+ currents was not affected by CBZ. In addition, the reduction of the Na+ current amplitude observed during repetitive stimulation with depolarizing pulses was not significantly altered by CBZ. CONCLUSIONS: In summary, CBZ strongly affects the voltage-dependent steady-state inactivation, with no effects on the removal of inactivation in Na+ currents of human DGCs. In spite of the lack of suitable control material, the CBZ insensitivity of the removal of inactivation may be an interesting concept to explain the medically intractable TLE in these patients.

Action Potentials↗

PubMed1999

Interictal epileptiform discharges in temporal lobe epilepsy due to hippocampal sclerosis versus medial temporal lobe tumors.

PURPOSE: It remains controversial whether a specific pattern of interictal epileptiform activity exists that may help to differentiate temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS) from other forms of TLE. In this study, we characterized the distribution of interictal epileptiform discharges in TLE due to HS as compared with those in patients with tumors restricted to the medial temporal lobe structures. METHODS: The study included 21 adult patients with unilateral HS who remained seizure free (>1 year) after anterior temporal lobectomy with amygdalohippocampectomy. Patients with "dual pathology" were excluded. The comparison group consisted of nine patients with tumors restricted to the amygdala and hippocampus. All patients underwent video-EEG monitoring preoperatively by using 39 scalp electrodes (including the 10-10 system over both temporal regions) and bilateral sphenoidal electrodes. RESULTS: The HS patient group showed a significantly higher percentage of ipsilateral epileptiform discharges maximal at anterior temporal electrodes (median, 97.0%; sphenoidal electrode alone, 88.1%), as compared with the tumor group (median, 72.1%; p<0.001; sphenoidal electrode alone, 24.8%; p<0.001). The HS group had significantly fewer extratemporal spikes/sharp waves (median, 0.0), as compared with the tumor group (10.0%; p<0.001). At least 90% of the interictal discharges were located in the anterior temporal region in 20 (95.2%) of 21 HS patients, but in none of the tumor patients (p<0.001). Bilateral temporal discharges were found in nine (42.9%) of 21 patients with HS and in two (22.2%) of nine tumor patients (p = 0.42). CONCLUSIONS: We conclude that ipsilateral interictal epileptiform discharges outside the anterior temporal region are rare (<10%) in adults with intractable TLE due to unilateral HS. Frequent posterior or extratemporal sharp waves may detract from the certainty of this diagnosis in complicated cases. These restricted epileptiform discharges suggest a smaller irritative zone in HS as compared with medial tumors, or a more organized activity associated with intrinsic hippocampal disease. Bilateral epileptiform discharges were not uncommon in both groups.

Adolescent↗

PubMed1999

The generalized tonic-clonic seizure in partial versus generalized epilepsy: semiologic differences.

PURPOSE: To study differences in the clinical manifestations of generalized tonic-clonic seizures (GTCS) of partial versus generalized onset. METHODS: We studied 10 GTCSs in nine patients with idiopathic generalized epilepsy (IGE) and 10 GTCSs in 10 patients with temporal lobe epilepsy (TLE). Videotaped seizures were reviewed for all clinical features, focusing on asymmetries during different phases of each seizure. RESULTS: In the IGE group, focal features were seen before generalized motor activity in seven seizures. The most common was adversive head turn (six seizures). One patient had opposite direction of head turning in two recorded seizures. The tonic phase was always symmetric. In the last generalized clonic phase, asymmetry or asynchrony of motor activity was seen transiently in three seizures. The TLE group showed focal features before generalization in all seizures. Adversive head turning occurred in nine patients and was always contralateral to the focus. Focal clonic activity occurred before generalization in three and was always contralateral to the focus. The generalized tonic phase was usually asymmetric, and in the last clonic phase, motor activity was asymmetric or asynchronous in eight seizures (p<0.05, IGE vs. TLE). CONCLUSIONS: Brief focal features or asymmetry at onset are common in the GTCSs of IGE. However, asymmetry or asynchrony during the last clonic phase are uncommon in IGE, in contrast to TLE.

Adolescent↗

PubMed2000

Frequency of bitemporal independent interictal epileptiform discharges in temporal lobe epilepsy.

PURPOSE: Bitemporal interictal epileptiform discharges (IEDs) occur in < or =42% of scalp EEGs in patients with temporal lobe epilepsy (TLE) studied with routine EEGs or partial analysis of long-term recordings. METHODS: Twenty-eight patients with TLE demonstrating exclusively unilateral temporal IEDs on routine EEGs underwent 24-h continuous recording. The entire record was visually inspected for epileptiform discharges. We used continuous EEG to assess the significance of long-term recording in detecting bilateral IEDs. RESULTS: Twenty-two patients had left temporal IEDs; 21 had right temporal IEDs. Seventeen (61%) patients had IEDs originating from both the right and left temporal lobes. The probability of detecting bilateral independent IEDs was correlated with the duration of continuous EEG recording. There was no correlation between the number of IEDs originating from one side and the probability of detecting independent IEDs on the other side. The frequencies of IEDs were not correlated with the length of time since onset of epilepsy. CONCLUSIONS: The findings suggest that when long-term recordings are performed, the incidence of bilateral discharges in TLE is higher than previously reported in the literature and supports the view that TLE is commonly a bilateral disease.

Adolescent↗

PubMed2000

Intracarotid amobarbital procedure and prediction of postoperative memory in patients with left temporal lobe epilepsy and hippocampal sclerosis.

PURPOSE: Although temporal lobe epilepsy (TLE) patients with dominant hemisphere hippocampal sclerosis generally have good cognitive outcome after anterior temporal lobectomy (ATL), a minority of patients experience at least mild post-ATL decline on one or more standardized measures of episodic and semantic memory. The goal of this investigation was to determine whether memory outcome in this group could be predicted from preoperative intracarotid amobarbital procedure (IAP) recognition memory scores. METHODS: Data from 22 left TLE patients were studied retrospectively. All were left hemisphere language dominant and had IAP scores for each hemisphere, a significant degree of pathology-confirmed left hippocampal sclerosis (HS+), and no positive MRI findings other than atrophy. Cognitive outcome status was represented by the number of pre- to post-ATL declines across three tests, as defined by 90th percentile Reliable Change Index (RCI) criteria. RESULTS: Only 14% of the sample exhibited decline on more than one memory test. Low right IAP (left hemisphere injection) scores and relatively high preoperative cognitive ability and age at surgery predicted a greater risk of post-ATL memory decline. CONCLUSIONS: A minority of left TLE HS+ patients experience at least a mild degree of RCI-defined decline in episodic or semantic memory after ATL. The right hemisphere IAP memory score, which reflects the functional reserve of the contralateral hemisphere, can help predict the risk of postoperative memory decline for TLE patients in whom HS+ is likely based on the presence of hippocampal atrophy on MRI or early age of seizure onset.

Adult↗

PubMed2000

Is epilepsy surgery possible in countries with limited resources?

This study illustrates the outcome and cost-effectiveness of anterior temporal lobectomy (ATL) among patients with medically refractory temporal lobe epilepsy (TLE) treated in an epilepsy center in Kerala, South India. Patients for ATL were selected on the basis of a noninvasive protocol comprising clinical, interictal scalp electroencephalogram (EEG), magnetic resonance imaging, and ictal video-EEG data. The authors compared the outcome and direct cost of 119 patients (mean age, 25.6 years; mean duration of epilepsy before ATL, 16.1 years) who have completed at least 1 year follow-up after ATL with 71 refractory TLE patients (mean age, 27.1 years; mean duration of epilepsy, 15.4 years) who did not undergo ATL. Patients in the study who underwent ATL had a 70% likelihood of becoming seizure-free after ATL and a 30% chance of being completely off of antiepileptic drug treatment within 3 years after ATL. The out-of-pocket one-time payment for ATL (including presurgical evaluation) in this setup is Indian Rupees (INR) 47,000 (US$ 1,200). The total direct medical cost of caring for TLE patients aged 26 to 60 years would be INR 200,000 (US$ 5,000). Patients freed from seizures often can be better employed and achieve an improved quality of life. It is concluded that ATL for refractory TLE is a more cost-effective option than continued medical treatment. Epilepsy surgery is not only possible in a developing country but can also be undertaken in a cost-effective way.

Adolescent↗

PubMed2000

Functional and molecular properties of human astrocytes in acute hippocampal slices obtained from patients with temporal lobe epilepsy.

PURPOSE: The specific role of glial cells in epilepsy is still elusive. In this study, functional properties of astrocytes were investigated in acute hippocampal brain slices obtained from surgical specimens of patients with drug-resistant temporal lobe epilepsy (TLE). METHODS: The patch-clamp technique together with a single-cell reverse transcription-polymerase chain reaction approach were used to combine functional and molecular analysis in the same individual cell in situ. RESULTS: In patients with Ammon's horn sclerosis, the glial current patterns resembled properties of immature astrocytes in rodent hippocampus. Depolarizing voltage steps activated delayed rectifier and transient K+ currents as well as tetrodotoxin-sensitive Na+ currents. Hyperpolarizing voltages elicited inward rectifier K+ currents. Comparative recordings were made in astrocytes from patients with lesion-associated TLE that lacked significant histopathological hippocampal alterations. The inward rectifier K+ current density was significantly smaller in astrocytes from the sclerotic group compared with lesion-associated TLE patients. CONCLUSIONS: During normal development of rodent brain, astroglial inward rectification gradually increases. It thus appears that astrocytes in human sclerotic tissue reexpress an immature current pattern. Reduced astroglial inward rectification in conjunction with seizure-induced shrinkage of the extracellular space may lead to impaired spatial K+ buffering. This will result in stronger and prolonged depolarization of glial cells and neurons in response to activity-dependent K+ release and may thus contribute to seizure generation and spread in this particular condition of human TLE.

Action Potentials↗

PubMed2005

Entorhinal cortex involvement in human mesial temporal lobe epilepsy: an electrophysiologic and volumetric study.

PURPOSE: Several studies have demonstrated diminution in the volume of entorhinal cortex (EC) ipsilateral to the pathologic side in patients with temporal lobe epilepsy (TLE). The relation between the degree of EC atrophy and the epileptogenicity of this structure has never been directly studied. The purpose of the study was to determine whether atrophy of the EC evaluated by the quantitative magnetic resonance imaging (MRI) method is correlated with the epileptogenicity of this structure in TLE. METHODS: Intracerebral recordings (SEEG method) of seizures from 11 patients with mesial TLE were analyzed. Seizures were classified according to patterns of onset: pattern 1 was the emergence of a low-frequency, high-amplitude rhythmic spiking followed by a tonic discharge, and pattern 2 was the emergence of a tonic discharge in the mesial structures. A nonlinear measure of SEEG signal interdependencies was used to evaluate the functional couplings occurring between hippocampus (Hip) and EC at seizure onset. MRI volumetric analysis was performed by using a T(1)-weighted three-dimensional gradient-echo sequence in TLE patients and 12 healthy subjects. RESULTS: Significant interactions between Hip and Ec were quantified at seizure onset. The EC was found to be the leader structure in most of the pattern 2 seizures. Volumetric measurements of EC demonstrated an atrophy in 63% of patients ipsilateral to the epileptic side. A significant correlation between the strength of EC-Hip coupling and the degree of atrophy was found. In addition, in those patients that had a normal EC volume, the EC was never the leader structure in Ec-Hip coupling. CONCLUSIONS: These results validate the potential role of volumetry to predict the epileptogenesis of the EC in patients with hippocampal sclerosis and MTLE.

Adolescent↗

PubMed2005

Is variation in the GABA(B) receptor 1 gene associated with temporal lobe epilepsy?

PURPOSE: gamma-Aminobutyric acid (GABA)-receptor genes are prime candidates for a role in seizure susceptibility. An association between the c.1465G-->A variant in the GABA(B) receptor 1 gene (GABBR1) and susceptibility to temporal lobe epilepsy (TLE) has been reported in an Italian cohort. We sought to replicate this association in an independent Australian cohort. METHODS: The 234 patients with TLE and 164 healthy controls were genotyped for the c.1465G-->A variant, by using inclusion criteria identical to those of the first study. RESULTS: The c.1465G-->A variant was found in one TLE patient and one control subject. Genotype and allele frequencies did not differ between groups. CONCLUSIONS: We did not replicate the reported associations between the c.1465G-->A variant and susceptibility to TLE. We suggest that the initial positive association may be due to undetected population stratification; the importance of genomic control is emphasized. Population-specific effects also may play a role, and we highlight the need to demonstrate an in vitro functional effect to give biologic meaning to any proposed association.

Adolescent↗

PubMed2006

Lack of association between a GABA receptor 1 gene polymorphism and temporal lobe epilepsy.

PURPOSE: Recently a coding nonsynonymous single-nucleotide polymorphism (SNP; G1465A) in the GABBR1 gene was reported to be associated with the incidence and severity of temporal lobe epilepsy (TLE). To clarify the role of this polymorphism in TLE, we attempted to replicate this study. METHODS: We genotyped 188 unrelated patients with TLE (110 women, 78 men) and 259 controls of middle European descent by a restriction-length polymerase chain reaction (PCR) assay. RESULTS: Only two (0.5%) patients and none of the controls exhibited the heterozygous A/G genotype, which was previously reported to be overrepresented among patients as compared with controls. CONCLUSIONS: Although our study was sufficiently powered, we could not replicate the original association. Potential reasons for this failure could lie in subtle genetic differences between the studied populations or differences in the TLE phenotypes.

Adolescent↗

PubMed2006

Effects of illness duration on memory processing of patients with temporal lobe epilepsy.

PURPOSE: To examine the effects of illness duration on the neural processing of memory in patients with temporal lobe epilepsy (TLE) by using functional MRI. METHODS: Twenty-three TLE patients (16 left, seven right) performed a complex visual scene-encoding task during functional MRI. Region-of-interest (ROI) analyses were used to quantity functional activation in the mesial temporal and frontal lobes. The patients' verbal and visual memory performances were evaluated by standardized neuropsychological tests. Analyses included group comparison and correlations of duration of epilepsy with functional activation and memory performance. RESULTS: Compared with normal controls, TLE patients demonstrated reduced activation bilaterally in the mesial temporal lobe (p=0.003), and the reduction was more pronounced on the ipsilateral side of the seizure focus. Moreover, a longer duration of illness was associated with fewer voxels activated in both the left (p=0.038) and right (p=0.017) mesial temporal lobe. Furthermore, the duration of illness was found to be significantly and negatively correlated with both verbal (p=0.020) and visual (p=0.000) memory functioning. CONCLUSIONS: TLE seems to affect the memory processes in the mesial temporal lobes progressively (i.e., the longer the duration of illness, the lower the brain activation). In turn, the reduction of brain activation negatively affects memory functioning. Finally, the reduction is not limited to the side of seizure but also is observed in the contralateral hemisphere.

Adolescent↗

PubMed2006

Facial emotion recognition after curative nondominant temporal lobectomy in patients with mesial temporal sclerosis.

PURPOSE: The right (nondominant) amygdala is crucial for processing facial emotion recognition (FER). Patients with temporal lobe epilepsy (TLE) associated with mesial temporal sclerosis (MTS) often incur right amygdalar damage, resulting in impaired FER if TLE onset occurred before age 6 years. Consequently, early right mesiotemporal insult has been hypothesized to impair plasticity, resulting in FER deficits, whereas damage after age 5 years results in no deficit. The authors performed this study to test this hypothesis in a uniformly seizure-free postsurgical population. METHODS: Controls (n=10), early-onset patients (n=7), and late-onset patients (n=5) were recruited. All patients had nondominant anteromedial temporal lobectomy (AMTL), Wada-confirmed left-hemisphere language dominance and memory support, MTS on both preoperative MRI and biopsy, and were Engel class I 5 years postoperatively. By using a standardized (Ekman and Friesen) human face series, subjects were asked to match the affect of one of two faces to that of a simultaneously presented target face. Target faces expressed fear, anger, or happiness. RESULTS: Statistical analysis revealed that the early-onset group had significantly impaired FER (measured by percentage of faces correct) for fear (p=0.036), whereas the FER of the late-onset group for fear was comparable to that of controls. FER for anger and happiness was comparable across all three groups. CONCLUSIONS: Despite seizure control/freedom after AMTL, early TLE onset continues to impair FER for frightened expressions (but not for angry or happy expression), whereas late TLE onset does not impair FER, with no indication that AMTL resulted in FER impairment. These results indicate that proper development of the right amygdala is necessary for optimal fear recognition, with other neural processes unable to compensate for early amygdalar damage.

Adolescent↗

PubMed2006

Decreased dopamine D2/D3-receptor binding in temporal lobe epilepsy: an [18F]fallypride PET study.

PURPOSE: Although animal data are suggestive, evidence for an alteration of the extrastriatal dopaminergic system in human focal epilepsy is missing. METHODS: To quantify D2/D3-receptor density, we studied seven patients with temporal lobe epilepsy (TLE) and nine age-matched controls with positron emission tomography (PET) by using the high-affinity dopamine D2/D3-receptor ligand [18F]Fallypride ([18F]FP) suitable for imaging extrastriatal binding. TLE was defined by interictal and ictal video-EEG, magnetic resonance imaging (MRI), and [18F]fluorodeoxyglucose ([18F]FDG)-PET and was due to hippocampal sclerosis (HS), based on histology in all patients. Primary analysis was based on regions of interest (ROIs) defined on individual MRIs. For each patient, binding potential (BP) was calculated by using the simplified reference tissue model, and the epileptogenic was compared with the unaffected hemisphere in each ROI. To confirm the results, an additional voxel-based group analysis was performed by using statistical parametric mapping. RESULTS: Compared with controls, [18F]FP BP was significantly decreased in the epileptogenic temporal lobe in all patients. On ROI analysis, this reduction was evident in areas surrounding the seizure-onset zone at the pole (-34.2%) and lateral aspects (-32.9%) of the temporal lobe. Although the hippocampus [18F]FDG uptake (-8.1%) and hippocampal MR volume (-35.1%) were significantly reduced, no significant decrease of [18F]FP BP was found. Reduction of [18F]FP BP did not correlate with hippocampal atrophy. CONCLUSIONS: D2/D3-receptor binding is reduced at the pole and in lateral aspects of the epileptogenic temporal lobe in patients with mesial TLE and HS. This area might correspond to "the irritative zone," indicating that D2/D3 receptors might play a specific role in the pathophysiology of mesial TLE.

Adult↗

PubMed2006

Extratemporal white matter abnormalities in mesial temporal lobe epilepsy demonstrated with diffusion tensor imaging.

PURPOSE: Recent studies have demonstrated bilateral white matter abnormalities in temporal lobe epilepsy (TLE) patients with unilateral mesial temporal sclerosis (MTS). The purpose of this project was to determine whether abnormalities of water diffusion are seen in extratemporal white matter of patients with TLE and pathologically confirmed MTS and to determine whether these findings are associated with worse surgical outcome. METHODS: Eleven patients with TLE and unilateral MTS confirmed in surgical specimens and 14 controls were studied by using cerebrospinal fluid-suppressed diffusion tensor imaging (DTI) and T2 relaxometry. RESULTS: Hippocampal T2 signal for patients was significantly elevated both ipsilateral (p<0.001) and contralateral (p=0.006) to MTS. DTI demonstrated reduced fractional anisotropy of the genu of the corpus callosum (p=0.003) and external capsule (p=0.02) and elevated mean diffusivity of the genu (p=0.005), splenium (p=0.03), and external capsule (p<0.001). For both the genu and external capsule, parallel diffusion of patients was not different from that of controls (genu, p=0.81; external capsule, p=0.45), whereas perpendicular diffusion was elevated (genu, p=0.001; external capsule, p<0.001). With mean postsurgical follow-up of 18.5 months, eight of 11 patients were entirely seizure free and the remaining three had all experienced a worthwhile reduction in seizure frequency. CONCLUSIONS: Our findings suggest that although patients with TLE and MTS have extensive bilateral and extratemporal pathology, these findings may not be associated with a worse postsurgical outcome.

Adult↗

PubMed2006

Interictal and postictal circadian and ultradian luteinizing hormone secretion in men with temporal lobe epilepsy.

PURPOSE: Hypothalamic regulation of the reproductive axis in temporal lobe epilepsy (TLE), represented by the ultradian pulsatile secretion of luteinizing hormone (LH), has been shown to be altered interictally and postictally. Our objective is to determine if epilepsy or seizures disrupt normal circadian fluctuations of LH as well as circadian organization of ultradian bursts of LH. METHODS: We characterized LH secretion in 10 men with TLE during two 24-h blocks: an interictal epoch and a postictal epoch initiated by a seizure. Serum LH was measured every 10 min and characterized by circadian and ultradian patterns with cosinor and deconvolution analysis. RESULTS: Mean peak serum concentrations of LH occurred at approximately 0400 in controls, were significantly delayed approximately 5 h interictally, and were randomly distributed postictally. Burst amplitudes differed significantly by phase among controls, with the largest amplitudes between 0101 and 0700 and the smallest between 1301 and 1900. No phase differences were present in interictal or postictal epochs. Burst frequency weakly but significantly was slowest between 0101 and 0700 in controls, but did not differ significantly by phase in either interictal or postictal epochs. Postictal LH burst frequencies, but not amplitudes, were significantly decreased immediately postictally. CONCLUSION: The pulsatile secretion of LH in TLE is abnormal both in the circadian as well as the ultradian domain. Interictal effects consist mainly in loss of circadian fluctuations in LH burst amplitude, whereas postictal effects consist of altered burst timing. Altered daily patterns of neuroendocrine signals may underlie other disorders of homeostasis in TLE.

Activity Cycles↗

PubMed2006

Cognitive outcomes in patients with chronic temporal lobe epilepsy.

Cognitive impairment is frequent in temporal lobe epilepsy (TLE). In particular, specific deficits in temporal lobe related functions occur, but deficits in extratemporal lobe functions and global intelligence are also found. The degree and type of the impairment are first determined by structural damage and functionally dynamic factors. Most cognitive problems in TLE are already detectable at, or even before, the onset of the epilepsy. Accumulation of damage during the course of chronic epilepsy may add to this. This additional damage may be caused directly by severe seizures, head trauma, intoxication etc., or indirectly by interference of the epilepsy with mental development. Surgical treatment of TLE may also affect the cognitive outcome of patients with chronic TLE, with a risk of additional impairments on the one hand and functional recovery due to seizure control on the other hand. With regard to patient-associated factors, better baseline performance, younger age, cerebral plasticity, and good mental reserve capacities are associated with a better outcome. With regard to treatment-associated factors, prevention of additional brain dysfunction/damage and successful seizure control are important.

Chronic Disease↗

PubMed1990

Event-related potential (P300) in epilepsy.

The P300 component of auditory event-related potential was studied in 39 patients with temporal lobe epilepsy (TLE), 26 with idiopathic generalized epilepsy (IGE) and 28 controls. The age-corrected P300 latencies were significantly longer in TLE patients compared with those in IGE patients and controls. Neither the duration of epilepsy nor clinical manifestation was related to the P300 component in the same epileptic syndrome. The age-corrected P300 latencies recorded from Cz were significantly prolonged in TLE patients with bilateral temporal EEG foci compared with those with unilateral focus. The effects of anti-epileptic drugs on the P300 component were not significant. Our findings imply that prolonged P300 latency in TLE patients, especially in those with bilateral EEG foci is due to damage of the hippocampus, which is potentially an epileptogenic focus.

Acoustic Stimulation↗

PubMed1986

The effect of phenytoin and carbamazepine on serum dehydroepiandrosterone sulfate in men and women who have partial seizures with temporal lobe involvement.

In a study of 16 men and 55 women with temporal lobe epilepsy (TLE), we found that the serum dehydroepiandrosterone sulfate (DHEA-S) level was significantly lower (P less than 0.05) in patients who were treated with phenytoin (mean +/- SD DHEA-S in men, 685 +/- 429 ng/ml; in women, 580 +/- 289), carbamazepine (women, 779 +/- 529), or a combination of the two drugs (men, 491 +/- 246; women, 474 +/- 284) than in age- and sex-matched untreated patients (men, 2634 +/- 418; women, 2011 +/- 1435) or in normal subjects (men, 2870 +/- 1052; women, 1764 +/- 617). DHEA-S values in the treated groups did not differ from one another. The DHEA-S levels in untreated patients with TLE did not differ significantly from those in normal subjects. TLE alone, therefore, is unlikely to account for the decrease in DHEA-S, and thus, the results suggest that the antiseizure medications are capable of reducing DHEA-S levels. These findings are important because DHEA-S levels are often measured as part of a battery of tests to assess endocrine function in conditions such as polycystic ovarian syndrome, which may be over-represented among women with TLE.

Adolescent↗