Article

Disorders of reproduction in patients with epilepsy: primary neurological mechanisms.

Harvard Medical School, Neuroendocrine Unit, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
Seizure (impact factor: 1.8). 04/2008; 17(2):101-10. DOI:10.1016/j.seizure.2007.11.025
Source: PubMed

ABSTRACT Reproductive disorders are unusually common among women and men with epilepsy. They are generally associated with and may be the consequence of reproductive endocrine disorders. Both epilepsy itself and antiepileptic drug use have been implicated in their pathophysiology. This review focuses on how temporolimbic dysfunction in epilepsy may disrupt normal neuroendocrine regulation and promote the development of reproductive endocrine disorders. The particular nature of the dysregulation may relate to the laterality and focality of the epilepsy and some hormonal changes may develop in close temporal relation to the occurrence of epileptiform discharges. In women, reproductive endocrine disorders include polycystic ovary syndrome, hypothalamic amenorrhea, functional hyperprolactinemia, and premature menopause. In men, hypogonadism may be hypogonadotropic, hypergonadotropic or related to hyperprolactinemia. The significance of these reproductive endocrine disorders is that they may contribute not only to sexual dysfunction and infertility but may also have an adverse impact on seizure control.

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Keywords

antiepileptic drug use
 
epilepsy
 
epileptiform discharges
 
hormonal changes
 
hypothalamic amenorrhea
 
infertility
 
normal neuroendocrine regulation
 
pathophysiology
 
polycystic ovary syndrome
 
premature menopause
 
reproductive endocrine disorders
 
seizure control
 
sexual dysfunction
 
temporal relation
 
temporolimbic dysfunction
 
women
 

Andrew G Herzog