Acute Hypothalamopituitary Dysfunction Following Interictal Unilateral Temporal Epileptiform Discharges in Women with Epilepsy
Abstract number :
G.02
Submission category :
Year :
2000
Submission ID :
732
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Andrew G Herzog, Anton E Coleman, Alan R Jacobs, Pavel Klein, Mark N Friedman, Frank W Drislane, Donald L Schomer, Beth Israel Deaconess Medical Ctr, Boston, MA; Oklahoma Univ Health Science Ctr, Oklahoma City, OK; New York Hosp - Cornell Medical Ctr, New
RATIONALE: Reproductive dysfunction is unusually common in women with epilepsy. This investigation assessed the occurrence of acute hypothalamopituitary dysfunction in relation to interictal unilateral temporal epileptiform discharges. METHODS: The subjects were 36 women with unilateral (20 left/16 right) temporolimbic epilepsy (TLE) and 12 normal controls, between 18-40 years of age, who had q 10 min serum samples drawn for luteinizing hormone (LH) and prolactin (PRL) levels from 8 AM to 4 PM during concomitant continuous EEG recording. RESULTS: Abnormal paroxysmal EEG discharges occurred in 26 of the 36 subjects. These consisted of unilateral temporal epileptiform discharges in 18 (10-left, 8-right). These discharges were frequently accompanied by acute disruptions of PRL and LH secretion that did not occur in controls. The most frequent disruption consisted of an abnormal elevation of PRL to peak values that exceeded 2 1/2 times the preceding nadir. This occurred in 15 of the 18 women with epilepsy (RTLE: 7 of 8, LTLE 8 of 10; TLE vs controls ?2: p < .01). Peak values were reached anywhere from 10-40 minutes after the onset of EEG discharges, with a return to baseline during the hour following their cessation. Abnormally high peak levels, i.e. above the control range, occured in 6 of the 8 women with RTLE but only 2 of the 10 women with LTLE (?2: p = .06). Protracted duration of EEG discharges was often associated with protracted elevation of PRL levels. In women with LTLE, PRL elevation was accompanied by a cessation of LH pulsatility in 80%. All had a subsequent resumption of pulsatility with a >50% higher mean baseline. In contrast, PRL elevation in women with RTLE was accompanied by an LH pulse cessation or subsequent >50% increase in mean baseline LH in only 25% (LTLE vs RTLE ?2: p = .06). CONCLUSIONS: Interictal unilateral temporal epileptiform discharges are commonly accompanied by acute abnormal changes in PRL and pulsatile LH secretion in women with epilepsy. The nature of the dysfunction may vary with the laterality of the epileptiform discharges. Supported by NIH RO1NS33189