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Clinical Epileptology

Erschienen in:

27.06.2023 | Übersichten

Gender-specific aspects in pediatric epileptology

verfasst von: Dr. Katharina Schiller, Veronika Schiller, Prof. Dr. Markus Rauchenzauner

Erschienen in: Clinical Epileptology | Ausgabe 3/2023

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Abstract

Background

Epilepsy is one of the most prevalent neurological disorders in children. Epilepsy, and the use of antiseizure medications (ASM), can influence the metabolic and endocrine systems. Particularly during puberty, it is crucial to consider gender-specific aspects in the treatment and management of epilepsy.

Objective

This narrative review outlines gender-specific factors in children with epilepsy regarding hormones, metabolism, and the effect of ASM.

Material and methods

Through a MEDLINE search with the keywords “epilepsy,” “children,” “gender,” and “hormone” or “metabolic,” relevant articles were selected and summarized. We tried to categorize the results into endocrinological and metabolic aspects that apply not only to both genders but also specifically to female and male patients with epilepsy.

Results

Children with epilepsy are at a greater risk of experiencing alterations in sexual and thyroid hormones as well as in bone markers depending on the ASM treatment. Female patients with epilepsy are at increased risk for obesity, amenorrhea, oligomenorrhea, anovulation, polycystic ovary syndrome, hyperandrogenism, and dyslipidemia. Male patients with epilepsy have a high likelihood of experiencing sexual dysfunction.

Conclusion

Metabolic and hormonal alterations are common in children with epilepsy. Gender-specific differences become more pronounced during puberty and are often correlated with ASM treatment.

Aaberg KM, Gunnes N, Bakken IJ, Lund Søraas C, Berntsen A, Magnus P et al (2017) Incidence and prevalence of childhood epilepsy: a nationwide cohort study. Pediatrics 139(5):e20163908. https://doi.org/10.1542/peds.2016-3908CrossRefPubMed

Taubøll E, Isojärvi JIT, Herzog AG (2021) The interactions between reproductive hormones and epilepsy. Handb Clin Neurol 182:155–174PubMed

Kim JY, Lee HW (2007) Metabolic and hormonal disturbances in women with epilepsy on antiepileptic drug monotherapy. Epilepsia 48(7):1366–1370PubMed

Patton GC, Viner R (2007) Pubertal transitions in health. Lancet 369(9567):1130–1139PubMed

Cameron JL (2004) Interrelationships between hormones, behavior, and affect during adolescence: understanding hormonal, physical, and brain changes occurring in association with pubertal activation of the reproductive axis. Introduction to part III. Ann N Y Acad Sci 1021:110–123PubMed

Bauer J (2001) Interactions between hormones and epilepsy in female patients. Epilepsia 42(3):20–22PubMed

Herzog AG, Seibel MM, Schomer DL, Vaitukaitis JL, Geschwind N (1986) Reproductive endocrine disorders in women with partial seizures of temporal lobe origin. Arch Neurol 43(4):341–346PubMed

Webber MP, Hauser WA, Ottman R, Annegers JF (1986) Fertility in persons with epilepsy: 1935–1974. Epilepsia 27(6):746–752PubMed

Dana-Haeri J, Trimble MR (1984) Prolactin and gonadotrophin changes following partial seizures in epileptic patients with and without psychopathology. Biol Psychiatry 19(3):329–336PubMed

10.

Mikati MA, Tarabay H, Khalil A, Rahi AC, El Banna D, Najjar S (2007) Risk factors for development of subclinical hypothyroidism during valproic acid therapy. J Pediatr 151(2):178–181PubMed

11.

Vainionpaa LK, Mikkonen K, Rattya J, Knip M, Pakarinen AJ, Myllyla VV et al (2004) Thyroid function in girls with epilepsy with carbamazepine, oxcarbazepine, or valproate monotherapy and after withdrawal of medication. Epilepsia 45(3):197–203PubMed

12.

Verrotti A, Scardapane A, Manco R, Chiarelli F (2008) Antiepileptic drugs and thyroid function. J Pediatr Endocrinol Metab 21(5):401–408PubMed

13.

Shi KL, Guo JX, Zhao HM, Hong H, Yang CZ, Wu YH et al (2020) The effect of levetiracetam and oxcarbazepine monotherapy on thyroid hormones and bone metabolism in children with epilepsy: a prospective study. Epilepsy Behav 113:107555PubMed

14.

Ilić V, Bogićević D, Miljković B, Ješić M, Kovačević M, Prostran M et al (2016) Duration of valproic acid monotherapy correlates with subclinical thyroid dysfunction in children with epilepsy. Epileptic Disord 18(2):181–186PubMed

15.

Lee YJ, Nam SO, Kim KM, Kim YM, Yeon GM (2017) Longitudinal change in thyroid hormone levels in children with epilepsy on a ketogenic diet: prevalence and risk factors. J Epilepsy Res 7(2):99–105PubMedPubMedCentral

16.

Mintzer S, Boppana P, Toguri J, DeSantis A (2006) Vitamin D levels and bone turnover in epilepsy patients taking carbamazepine or oxcarbazepine. Epilepsia 47(3):510–515PubMed

17.

Isojärvi JI (1990) Serum steroid hormones and pituitary function in female epileptic patients during carbamazepine therapy. Epilepsia 31(4):438–445PubMed

18.

Rauchenzauner M, Griesmacher A, Tatarczyk T, Haberlandt E, Strasak A, Zimmerhackl LB et al (2010) Chronic antiepileptic monotherapy, bone metabolism, and body composition in non-institutionalized children. Dev Med Child Neurol 52(3):283–288PubMed

19.

Petty SJ, O’Brien TJ, Wark JD (2007) Anti-epileptic medication and bone health. Osteoporos Int 18(2):129–142PubMed

20.

El-Khayat HA, Abd El-Basset FZ, Tomoum HY, Tohamy SM, Zaky AA, Mohamed MS et al (2004) Physical growth and endocrinal disorders during pubertal maturation in girls with epilepsy. Epilepsia 45(9):1106–1115PubMed

21.

Luef G, Abraham I, Haslinger M, Trinka E, Seppi K, Unterberger I et al (2002) Polycystic ovaries, obesity and insulin resistance in women with epilepsy. A comparative study of carbamazepine and valproic acid in 105 women. J Neurol 249(7):835–841PubMed

22.

Vainionpaa LK, Rattya J, Knip M, Tapanainen JS, Pakarinen AJ, Lanning P et al (1999) Valproate-induced hyperandrogenism during pubertal maturation in girls with epilepsy. Ann Neurol 45(4):444–450PubMed

23.

Herzog AG, Coleman AE, Jacobs AR, Klein P, Friedman MN, Drislane FW et al (2003) Relationship of sexual dysfunction to epilepsy laterality and reproductive hormone levels in women. Epilepsy Behav 4(4):407–413PubMed

24.

Isojarvi JI, Laatikainen TJ, Pakarinen AJ, Juntunen KT, Myllyla VV (1995) Menstrual disorders in women with epilepsy receiving carbamazepine. Epilepsia 36(7):676–681PubMed

25.

Morrell MJ, Montouris GD (2004) Reproductive disturbances in patients with epilepsy. Cleve Clin J Med 71(2):S19–24PubMed

26.

McEwen BS, Alves SE (1999) Estrogen actions in the central nervous system. Endocr Rev 20(3):279–307PubMed

27.

Scharfman HE, MacLusky NJ (2006) The influence of gonadal hormones on neuronal excitability, seizures, and epilepsy in the female. Epilepsia 47(9):1423–1440PubMedPubMedCentral

28.

Isojarvi JI, Laatikainen TJ, Knip M, Pakarinen AJ, Juntunen KT, Myllyla VV (1996) Obesity and endocrine disorders in women taking valproate for epilepsy. Ann Neurol 39(5):579–584PubMed

29.

Balen A (1999) Pathogenesis of polycystic ovary syndrome—the enigma unravels? Lancet 354(9183):966–967PubMed

30.

Luef G, Abraham I, Trinka E, Alge A, Windisch J, Daxenbichler G et al (2002) Hyperandrogenism, postprandial hyperinsulinism and the risk of PCOS in a cross sectional study of women with epilepsy treated with valproate. Epilepsy Res 48(1–2):91–102PubMed

31.

Franks S (1995) Polycystic ovary syndrome. N Engl J Med 333(13):853–861PubMed

32.

Conway GS, Agrawal R, Betteridge DJ, Jacobs HS (1992) Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome. Clin Endocrinol (Oxf) 37(2):119–125PubMed

33.

Isojarvi JI, Laatikainen TJ, Pakarinen AJ, Juntunen KT, Myllyla VV (1993) Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med 329(19):1383–1388PubMed

34.

Mikkonen K, Vainionpaa LK, Pakarinen AJ, Knip M, Jarvela IY, Tapanainen JS et al (2004) Long-term reproductive endocrine health in young women with epilepsy during puberty. Neurology 62(3):445–450PubMed

35.

Rättyä J, Pakarinen AJ, Knip M, Repo-Outakoski M, Myllylä VV, Isojärvi JI (2001) Early hormonal changes during valproate or carbamazepine treatment: a 3-month study. Neurology 57(3):440–444PubMed

36.

Löfgren E, Tapanainen JS, Koivunen R, Pakarinen A, Isojärvi JI (2006) Effects of carbamazepine and oxcarbazepine on the reproductive endocrine function in women with epilepsy. Epilepsia 47(9):1441–1446PubMed

37.

Laidlaw J (1956) Catamenial epilepsy. Lancet 271(6955):1235–1237PubMed

38.

Herzog AG (2022) Association between family history of alcohol use disorder and catamenial epilepsy. Epilepsia 63(6):e63–e7PubMed

39.

Herzog AG, Klein P, Ransil BJ (1997) Three patterns of catamenial epilepsy. Epilepsia 38(10):1082–1088PubMed

40.

Foldvary-Schaefer N, Falcone T (2003) Catamenial epilepsy: pathophysiology, diagnosis, and management. Neurology 61(6):S2–15PubMed

41.

Maguire MJ, Nevitt SJ (2021) Treatments for seizures in catamenial (menstrual-related) epilepsy. Cochrane Database Syst Rev 9(9):Cd13225PubMed

42.

Beier CP, García Rodríguez LA, Sáez ME, Gaist D, González-Pérez A (2018) Hormonal contraception is not associated with increased risk for seizures in the general population: results from a cohort study using the health improvement network. Eur J Clin Pharmacol 74(9):1175–1180PubMed

43.

Herzog AG (2015) Differential impact of antiepileptic drugs on the effects of contraceptive methods on seizures: Interim findings of the epilepsy birth control registry. Seizure 28:71–75PubMed

44.

Anderson S, Mauskopf J, Talbird SE, White A, Srinivasan M (2021) Antiseizure medications and oral contraceptives: impact of enzyme inducers on pregnancy outcomes and costs. Epilepsy Behav 125:108368PubMedPubMedCentral

45.

Moseley BD, Chanteux H, Nicolas JM, Laloyaux C, Gidal B, Stockis A (2020) A review of the drug-drug interactions of the antiepileptic drug brivaracetam. Epilepsy Res 163:106327PubMed

46.

Rauchenzauner M, Deichmann S, Pittschieler S, Bergmann M, Prieschl M, Unterberger I et al (2020) Bidirectional interaction between oral contraception and lamotrigine in women with epilepsy—role of progestins. Seizure 74:89–92PubMed

47.

Wegner I, Wilhelm AJ, Lambrechts DA, Sander JW, Lindhout D (2014) Effect of oral contraceptives on lamotrigine levels depends on comedication. Acta Neurol Scand 129(6):393–398PubMed

48.

Reimers A (2016) Contraception for women with epilepsy: counseling, choices, and concerns. Open Access J Contracept 7:69–76PubMedPubMedCentral

49.

Davis AR, Saadatmand HJ, Pack A (2016) Women with epilepsy initiating a progestin IUD: a prospective pilot study of safety and acceptability. Epilepsia 57(11):1843–1848PubMed

50.

Toone BK, Wheeler M, Fenwick PB (1980) Sex hormone changes in male epileptics. Clin Endocrinol (Oxf) 12(4):391–395PubMed

51.

Bauer J, Blumenthal S, Reuber M, Stoffel-Wagner B (2004) Epilepsy syndrome, focus location, and treatment choice affect testicular function in men with epilepsy. Neurology 62(2):243–246PubMed

52.

Herzog AG, Drislane FW, Schomer DL, Pennell PB, Bromfield EB, Dworetzky BA et al (2005) Differential effects of antiepileptic drugs on sexual function and hormones in men with epilepsy. Neurology 65(7):1016–1020PubMed

53.

Talbot JA, Sheldrick R, Caswell H, Duncan S (2008) Sexual function in men with epilepsy: how important is testosterone? Neurology 70(16):1346–1352PubMed

54.

Rathore C, Henning OJ, Luef G, Radhakrishnan K (2019) Sexual dysfunction in people with epilepsy. Epilepsy Behav 100:106495PubMed

55.

Tallon E, O’Donovan L, Delanty N (2021) Reversible male infertility with valproate use: a review of the literature. Epilepsy Behav Rep 16:100446PubMedPubMedCentral

Titel: Gender-specific aspects in pediatric epileptology
verfasst von: Dr. Katharina Schiller
Veronika Schiller
Prof. Dr. Markus Rauchenzauner
Publikationsdatum: 27.06.2023
Verlag: Springer Medizin
Erschienen in: Clinical Epileptology / Ausgabe 3/2023
Print ISSN: 2948-104X
Elektronische ISSN: 2948-1058
DOI: https://doi.org/10.1007/s10309-023-00606-z

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Material and methods

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