Endocrine Function and Growth in Young Patients with Childhood- or Adolescence-onset Epilepsy

Endocrine disorders are common in adults with epilepsy on antiepileptic drugs (AEDs). This study aimed to evaluate endocrine function, lipid metabolism and growth in patients with childhoodor adolescence-onset epilepsy. Altogether 148 patients with epilepsy on carbamazepine (CBZ), oxcarbazepine (OXC), valproate (VPA) or lamotrigine monotherapy during pubertal maturation and 124 healthy controls participated in this population-based cohort study. Boys and young men (n = 140) underwent cross-sectional evaluation once, and girls and young women (n = 132) twice at an approximate interval of 6 years. Gonadal structure and serum reproductive and thyroid hormone and lipid concentrations were evaluated and growth data were gathered. Elevated serum testosterone and androstenedione levels and polycystic ovary syndrome (PCOS) were common in female subjects whose medication, especially VPA, continued into young adulthood. Serum reproductive hormone concentrations and ovarian structure were similar in patients off medication and controls in young adulthood. CBZ was associated with elevated serum sex hormone binding globulin and decreased dehydroepiandrosterone sulfate levels and VPA with elevated serum androstenedione concentrations in male patients. Testicular structure was similar in patients and controls. CBZ, OXC and VPA were associated with changes in serum thyroid hormone, thyrotropin and lipid levels during pubertal maturation in female patients, but these levels returned to normal after withdrawal of medication. Linear growth and final height were normal in female patients, but overweight was common if they had been obese and on VPA medication during pubertal maturation. Elevated serum androgen levels, PCOS and overweight are common if epilepsy and AED use, especially VPA, continue into young adulthood. These untoward changes or alterations in serum thyroid hormone or lipid concentrations are not present in young women with medication withdrawn. CBZ and VPA are associated with changes in serum sex hormone levels in boys and young men with epilepsy. Epilepsy and AED use during pubertal maturation does not seem to affect growth.