How do hormones and epilepsy interact?

Hormones affect seizures, and seizures affect hormonal regulation and secretion. Seizures cause both acute and chronic alterations in hormonal secretions. Some of the acute changes (such as a postictal increase in prolactin secretion) can be used as a diagnostic aid. Some chronic changes, such as those affecting reproductive and sexual functioning, may impair the patient's life in ways that may be significantly improved by treatment.

Women with epilepsy encounter several types of problems involving hormones:

• changes in seizures produced by gonadal steroids, such as catamenial epilepsy
• changes in seizures when endocrine status changes, such as during menarche, pregnancy, and menopause
• effect of seizures on endocrine reproductive function, such as ovulation and sexuality

In men with epilepsy, the most common endocrine problem is altered sexuality, usually hyposexuality.

In both men and women with epilepsy, antiepileptic drugs (AEDs) may affect endocrine function, producing clinically important consequences.

Awareness of how various hormones relieve or exacerbate seizures may lead to improvement in the treatment of seizures. In both men and women, hormonal treatments are currently being explored for their usefulness as adjunctive anticonvulsant therapy.

This website will not discuss other hormone-related conditions that lower seizure thresholds in people with epilepsy and may trigger de novo situational seizures:

• thyrotoxicosis
• hyponatremia associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH)
• hypoglycemia

Information about these disorders is found in all standard medical textbooks.

Adapted from: Klein P and Herzog AG. Endocrine aspects of partial seizures. In: Schachter SC, Schomer DL, eds. The comprehensive evaluation and treatment of epilepsy. San Diego, CA: Academic Press; 1997. p. 207-232.
With permission from Elsevier (www.elsevier.com).
Reviewed and revised February 2004 by Cynthia Harden, MD, Weill Cornell Medical College.