SERUM SEX-HORMONES ARE ALTERED IN PATIENTS WITH CHRONIC TEMPORAL-LOBEEPILEPSY RECEIVING ANTICONVULSANT MEDICATION

Purpose: To evaluate the changes in serum sex hormones of gonadal or a drenal origin, the gonadotropic hormones, and sex hormone-binding glob ulin (SHBG) in men and women with chronic temporal lobe epilepsy (TLE) , who an undergoing monotherapy with carbamazepine or receiving carbam azepine in combination with other anticonvulsant drugs. Methods: Gonad al hormones (estradiol, testosterone, free testosterone, and inhibin B ), adrenal hormones [cortisol, dehydroepiandrosterone sulfate (DHEAS), androstenedione, and 17 alpha-hydroxyprogesterone], and gonadotropic hormones (luteinizing hormone [LH] and follicle-stimulating hormone [F SH]) were measured in 22 women and 26 men with TLE. The study also mea sured prolactin; human growth hormone and its major mediator, insulin- like growth factor-I; thyroid hormones (free thyroxine and free triiod othyronine); thyroid-stimulating hormone (TSH); and SHBG. The results were compared with those obtained from 60 healthy women and 106 health y men. Results: In the female patients, TSH, DHEAS, follicular-phase L H, and luteal-phase estradiol were significantly lower than in the con trol groups, with prolactin and SHBG significantly higher. In the male patients, DHEAS, 17 alpha-hydroxyprogesterone, free testosterone, inh ibin B, and the testosterone/LH ratio were significantly lower than in the control group, with LH, FSH, and SHBG significantly higher. Incre ased FSH in 31%, of the men indicates an impairment of spermatogenesis ; lowered inhibin B in 12% indicates an impaired Sertoli's cell functi on; and the decreased testosterone/LH ratio in 50% indicates an impair ed Leydig's cell function. Conclusions: The case patients had endocrin e disorders, mainly concerning the gonadotropic and gonadal functions in both sexes; the adrenal function, with lowered DHEAS levels in both sexes; and lowered 17a-hydroxyprogesterone levels in the men. SHBG le vels were increased in patients taking anticonvulsant medications.