Print version ISSN 0004-282X
Arq. Neuro-Psiquiatr. vol.55 no.3A São Paulo Sept. 1997
Hormonal dysfunction in human reproduction and complex partial seizures (abstract)*
Disfunção hormonal em reprodução humana e epilepsias parciais complexas (resumo)
Paulo Diniz da Gama**
Hormonal dysfunction in human reproduction and complex partial seizures (abstract). Dissertation. São Paulo, 1977.
The decrease of fertility in epileptic women has been reported since 1950 and has been confirmed by recent epidemiologic studies. This phenomenon could be attributed to the use of antiepileptic drugs, psychosocial disruptions or hyposexuality, almost frequently observed in the epileptic patients. Lately, endocrine syndromes have also been reported in epileptic women and these syndromes have been connected to the decrease of fertility. We refer in particular to the polycystic ovarian syndrome, which occurs more frequently in women who are carriers of epilepsy, if compared with the general population. Some points could be considered when we try to explain this phenomenon.
At first, it might be that the epileptic activity, through paroxysmal discharges reaching the hypothalamus, affected the hormonal activity, particularly the pulse generator of gonadotropin releasing hormone (GnRH).
On the other hand, endocrine changes resulting from anovulatory cycles could be related to the breaking out of epileptic discharges, possibly by direct action from this abnormally high hormonal concentration in the limbic structures.
At last, the decrease of epileptic seizures threshold and the dysfunction of GnRH secretion could be connected to an alteration of the neurotransmitters balance.
These aspects, isolated or on the whole, could be responsible for the alteration of pulsatility of luteinizing hormone. This fact, at a long term period and under effect of further factors, could come to light as endocrine changes in the reproductive region with clinical effects.
The main objective of this investigation is to study on the torch of the available literature, the possible connection between epileptic seizures from the temporal lobe and the polycystic ovarian syndrome. This investigation also makes comments on revised data of the existing literature regarding to the involved anatomic structures, the performance of antiepileptic drugs, and the possible interference of psychosocial factors.
Key words: epilepsy, complex partial seizures, hormonal dysfunction, luteinizing hormone.
* Dissertação de Mestrado, Faculdade de Medicina da Universidade de São Paulo (Área: Neurologia). Orientador: Luís dos Ramos Machado.
** Address: Rua Conde Francisco Matarazzo 58, 18030-010 Sorocaba SP.