Hormones and Epilepsy

Hormones are crucial systemic players and act at different sites of the entire body including the brain. The brain is not only the target of hormone action, but also serves as the “conductor” of the “neuro-endocrine symphony”. Changes in neuronal activity, such as seizures in epileptic patients, may affect hormonal regulation and secretion. In turn, hormones modify susceptibility to develop seizures. Epilepsy itself may directly influence the endocrine control centres, the hypothalamic-pituitary axis, thus altering the release of gonadotropin releasing hormone and therefore affect gonadal hormone concentrations resulting in changed sexual function. Awareness of how hormones relieve or exacerbate seizure frequency and severity, as well as of how seizures and epilepsy may significantly affect reproductive and sexual function by interacting with hormone secretion and metabolism is important. In addition, not only changes in neuronal activity may affect hormone secretion and metabolism in patients with epilepsy, but also antiepileptic drugs may have deleterious effects. In summary, epilepsy, antiepileptic drugs and hormones display complex interactions. Hormones may alter seizure threshold, change the frequency and severity of seizures. In turn, epilepsy and/or antiepileptic drugs can compromise the reproductive hormonal and sexual functions in women and man. A better understanding of hormone – brain interactions should promote a variety of innovative approaches to an improved treatment of epilepsy through both behavioural and pharmaceutical interventions.