Abstracts

Rationale: Sex hormone levels in women with epilepsy (WWE) have been thought to be affected by epilepsy and antiepileptic drugs. On the other hand, hormones including estrogen (E) and progesterone (P) can also promote or inhibit seizure. Some hormones such as anti-Mullerian hormone (AMH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) have close correlation with polycystic ovary syndrome (PCOS), which is more common in WWE. However, these hormone levels in WWE without PCOS were rarely studied. Therefore, this study aims to explore the relationship between seizure frequency and serum sex hormone levels in WWE without PCOS. Methods: Female outpatients aged 12-48 visiting epilepsy clinics at West China Hospital were recruited from July 2015 to May 2019, and women with PCOS were excluded. Seizure frequency of each patient during last six months was obtained from the electronic medical record and the epilepsy diaries of the patients. Serum concentrations of AMH, LH, FSH, P, estradiol (E2), testosterone (T), and prolactin (PRL) of each patient were detected between the second and the fifth day of menstrual period. Results: Totally, 123 WWE were enrolled and their serum hormone concentrations were tested. Seventy-one women divided into the first group experienced seizure attack less than once a month and the other 52 women had at least one seizure a month during the last six months. Mean ages of the patients was not different between the two groups (24.9±7.7 vs 24.9±8.3y, p=0.985) but their mean courses of epilepsy were significantly different (6.2±6.5 vs 9.0 vs. 7.9y, p=0.037). The mean serum LH level (5.26±2.32 vs. 6.47±3.81mIU/ml, p=0.047) and the mean LH/FSH ratio (0.85±0.45 vs. 1.10±0.74, p=0.032) was higher while the average AMH level (4.46±2.34 vs. 4.00±2.32ng/ml, p=0.307) was lower in WWE with at least one seizure a month. According to the binary logistic regression, WWE with higher LH/FSH ratio were more likely to experience epileptic seizure every month or more often (p=0.031, OR 0.801, CI95% 0.655, 0.980). On the contrary, higher AMH level suggested a lower risk of high seizure frequency (p=0.009, OR 3.762, CI95% 1.390, 10.181). Conclusions: High LH/FSH radio not just implies a higher risk for PCOS but also suggests a greater possibility of frequent seizures in WWE without PCOS. In contrast, higher serum AMH level is often closely related to a lower seizure frequency. Funding: No funding