Serum androgens return to normal after temporal lobe epilepsy surgery in men

Background: Epileptic discharges from the temporal robe may influence the r elease of hormones from the hypothalamic-pituitary axis. If epilepsy surger y influences the underlying epileptic disorder one might expect serum hormo ne concentrations to return to normal following surgery. Patients: Twenty-t wo men with epilepsy aged 25 to 48 years (mean, 34.9 years) were investigat ed before surgery and at 3, 6, and 12 months after surgery. Medication (all patients received carbamazepine) was maintained following surgery. Methods : Hormone measurements included luteinizing hormone, follicle stimulating h ormone, estradiol, testosterone, free testosterone, androstenedione, prolac tin, dehydroepiandrosterone sulfate, cortisol, growth hormone, and sex horm one-binding globulin. These hormone levels mere compared with those of 105 healthy men (mean age, 33.9 years). Results: Fourteen of the 22 patients (6 3.6%) achieved total seizure control following epilepsy surgery. The 14 pat ients with successful seizure control entered further analysis. Before surg ery these patients' free testosterone and androstenedione concentrations we re significantly lower compared with healthy men. In seven of the 14 patien ts a significant increase of hormone serum concentrations could be demonstr ated for testosterone, free testosterone, and androstenedione. Laterality o f epileptic focus, enzyme-inducing medication, stress, and the decreasing n umber of patients during the follow-up did not correlate with the finding o f a normalization of serum androgens. Patients without complete seizure con trol did not show an increase in serum androgen concentrations. Conclusion. Successful temporal lobe epilepsy surgery may lead to a normalization of s erum androgen concentrations in men with epilepsy.